Korean J Neurotrauma.  2016 Oct;12(2):112-117. 10.13004/kjnt.2016.12.2.112.

Effectiveness of Cortical Atrophy Scale and Indirect Indices of Brain Atrophy to Predict Chronic Subdural Hematoma in Older Patients

• Jeong EO
• Choi SW
• Lim JW
• Kwon HJ
• Kim SH
• Koh HS
• Youm JY
• Song SH

• KMID: 2356783
• DOI: http://doi.org/10.13004/kjnt.2016.12.2.112

Abstract

OBJECTIVE
To determine whether baseline cerebral atrophy can predict the rate of future chronic subdural hematoma (CSDH) after head trauma and compare indirect markers of brain atrophy with volumetric analysis of computed tomography (CT).
METHODS
Single institution case-control study involving 1,476 patients who visited our hospital after head trauma from January 2009 to December 2014. Forty-one patients with delayed CSDH were identified and age, gender matched 41 patients were selected as control group. Both volumetric analyze on CT and Evans index, frontal horn index, bicaudate ratio, sylvian fissure ratio and cortical atrophy scale of 82 patients were estimated by different raters and relationship of those factors with CSDH was analyzed.
RESULTS
Every indirect indices except cortical atrophy scale were not enough to give a good estimate of CSDH. Brain atrophy and cortical atrophy scale were predisposing factors of CSDH on multivariate analysis with statistical significance.
CONCLUSION
Brain atrophy was a potential prognostic factor of CSDH after trauma. In practice, patients with a value of cortical atrophy scale over moderate grade needed more attention for CSDH.

Keyword

Analysis; Atrophy; Brain; Evaluation studies as topic; Hematoma, subdural, chronic

MeSH Terms

Animals
Atrophy*
Brain*
Case-Control Studies
Causality
Craniocerebral Trauma
Evaluation Studies as Topic
Hematoma, Subdural, Chronic*
Horns
Humans
Multivariate Analysis

Figure

• 

  FIGURE 1 Volume measurement of Gamma-Plan program (Elekta instrument AB, Stockholm, Sweden) by sequential volume mapping. (A) Black line contain Intracranial volume. (B) Black lilne contain cerebrospinal fluid volume.

• 

  FIGURE 2 Brain computed tomography examples of cortical atrophy scale. (A) Absent atrophy. (B) Mild atrophy. (C) Moderate atrophy. (D) Severe atrophy.

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