Clinical Analysis of Severe Head Injury

Park, Dong Soo; Kim, Jong Moon

Abstract

The present study is made to evaluate prognostic factors in 67 patients with severe head injuries collected from entire 617 head-injured patients who were admitted to the Department of Neurosurgery, Won Kwang University Hospital from January, 1984 to December, 1985. The results were as follows : 1) The mortality rate in the different age group was as follows : 37.8% for patients aged 40 years and less, and 72.7% for those over 40 years old. The difference in mortality was significant. 2) The mortality rate increased steadily as the GCS score on admission decreased. 3) The mortality rate increased steadily in sequence of the motor response of localizing, withdrawal, abnormal flexion, abnormal extension, and flaccidity. The difference in mortality was significant only between abnormal flexion and abnormal extension. 4) The mortality rate was significantly higher in patients without pupillary light reflex than those with reflex. 5) The mortality rate observed in patients operated on for a intracranial mass lesion was 57.1% and the mortality rate in patients not undergoing surgery was 40.6%. The difference was not statistically significant. 6) In the overall outcome of 67 patients, 7.5% made a good recovery, 23.9% were moderately disabled, 11.9% were left severly disabled, 7.4% were vegetative, and 49.3% of the patients died.