@article{ref1,
title="Outcome after severe head injury: Focal surgical lesions do not imply a better Glasgow Outcome Score than diffuse injuries at 3 months",
journal="Journal of trauma management and outcomes",
year="2009",
author="Leach, Paul and Pathmanaban, Omar N. and Patel, H. C. and Evans, Joanne and Sacho, Raphael and Protheroe, Richard and King, Andrew T.",
volume="3",
number="1",
pages="5-5",
abstract="BACKGROUND: Historically neurosurgeons have accepted head injured patients only in the presence of a mass lesion requiring surgical decompression. Underpinning this is an assumption that these patients have a better outcome than patients without a surgical lesion. This has meant that many patients without a surgical lesion have been managed locally in the referring hospital. However, there is now evidence that treatment of all head injured patients in a specialist centre leads to improved outcomes. Therefore, we have asked the question: does the presence of a surgical lesion imply better outcome from severe head injury? RESULTS: We prospectively recorded the Glasgow Outcome score (GOS), at 3 months, of all the severely head injured patients treated at our institution over a two and a half year period. Of 116 patients admitted with an initial Glasgow Coma Score (GCS) of 8 or less, 58 had surgical lesions and 58 non-surgical head injuries. The two groups were well matched for presenting GCS and age. Overall our favourable outcome rate (GOS 4 and 5) at 3-months for the patients with a surgical lesion and for the non-surgical group were 47.3% and 46.6% respectively, with no significant difference between the two (P= 0.54). CONCLUSIONS: The assumption in the past has always been that patients presenting in coma from traumatic diffuse brain injury will do worse than those that have a mass lesion amenable to surgical decompression. Our series would suggest that this is not the case and all severely head injured patients should expect similar outcome when cared for in a neuroscience centre.<p /> <p>Language: en</p>",
language="en",
issn="1752-2897",
doi="10.1186/1752-2897-3-5",
url="http://dx.doi.org/10.1186/1752-2897-3-5"
}