The Relationship between Brain Computed Tomography Scan Findings and Prognosis in Patients with Missile-penetrating Head Injuries

Abstract

Background: Missile-penetrating head injury is a challenging problem for treating physicians. In Iraq and during 2003–2007, there was a civil war, which led to multiple causalities after suicide bombings or other clashes with coalition forces. A brain computed tomography (BCT) scan is considered as an initial diagnostic test to evaluate the next management plan. The authors tried to find the relationship between BCT scan findings and patients’ outcomes. Objective: This study aimed to explore the relationship between BCT scan findings of patients with missile-penetrating head injury and their prognosis. Materials and Methods: This was a cohort retrospective clinical study performed in Karbala, Iraq in the period from January 2005 till January 2006. Seventy patients with missile-penetrating head injuries were admitted and evaluated in Al-Hussain General Hospital (affiliated with the University of Al-Ameed). All patients had BCT scans and their outcome was evaluated using a modified Glasgow Outcome Scale. Results: In this study, the mortality rate is 15.71%. BCT scan findings are correlated with patients’ outcomes, which revealed the injury of one lobe carries the best outcome, whereas those with more than two lobes or posterior fossa injury carry the worse prognosis. Moreover, intraventricular hemorrhage (IVH) showed the highest mortality rate, whereas tract hematoma alone seems to carry a good prognosis with the least mortality. Conclusion: BCT scan is essential in both diagnosis and prognosis of patients with missile-penetrating head injury. IVH and posterior fossa injury lead to the highest mortality rate.