Clinical Features of Repeated Head Injury

Shin, Sang Ha; Whang, Kum; Kim, Hun Joo; Han, Yong Pyo; Hu, Chul; Pyen, Jhin Soo

Abstract

OBJECTIVE
The aim of this study is to evaluate the clinical outcome of the repeated head injury.
METHODS
The medical records of 12 patients with repeated head injury from January, 1998 to December, 2004 were reviewed retrospectively concerning the etiology, combined injury, intracranial pathology, treatment regimen, Glasgow Coma Scale (GCS) on admission and Glasgow Outcome Scale (GOS) after first and second head injury at discharge.
RESULTS
Mean transit time from first to second injury was 37.6 months. The most common etiology of first and second injury was pedestrian accident. The past history revealed alcoholism, pre-existing deafness, hypertension, and diabetes. six patients with first head injury received cranial operation, while only 2 patients with repeated head injury underwent surgery. Intracranial pathology after repeated head injuries were revealed mainly frontal and temporal lobe contusion. Of all intracranial pathologies found after the second injury, about 50% of revealed lesions were shown identical to the first injury sites. The GCS scores after the repeated injury was 9 or higher in 9 cases, and below 9 in 3 cases. The GOS score of the repeated injury at discharge was good recovery in 9 cases. Otherwise all was 1 case in moderate disability, severe disability, and death case, respectively.
CONCLUSION
The patients with repeated head injury were mostly male, and it frequently disclosed a history of alcoholism. Also, the severity is mostly mild, and therefore tends to show a good prognosis. These were mostly shown in the same area as the first injury in the form of encephalomalacia after first head injury.