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The Prognosis of Axial vs. Extra-Axial Lesions on Functional Status After Traumatic Brain Injury

Background: Head computed tomography (CT) scans are widely used in acute head injury for medical triage and surgical decisions, yet there are contradictions on the prognostic value of different head CT classifications. The intra-axial (axial) lesion vs. extra-axial lesion is a well-known systemic cl...

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Autores principales: Quach, Nhung, Do, Jacqueline, Dirlikov, Benjamin, Ehsanian, Reza, Pasipanodya, Elizabeth C., Ali, Arshad, Duong, Thao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838132/
https://www.ncbi.nlm.nih.gov/pubmed/31736869
http://dx.doi.org/10.3389/fneur.2019.01167
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author Quach, Nhung
Do, Jacqueline
Dirlikov, Benjamin
Ehsanian, Reza
Pasipanodya, Elizabeth C.
Ali, Arshad
Duong, Thao
author_facet Quach, Nhung
Do, Jacqueline
Dirlikov, Benjamin
Ehsanian, Reza
Pasipanodya, Elizabeth C.
Ali, Arshad
Duong, Thao
author_sort Quach, Nhung
collection PubMed
description Background: Head computed tomography (CT) scans are widely used in acute head injury for medical triage and surgical decisions, yet there are contradictions on the prognostic value of different head CT classifications. The intra-axial (axial) lesion vs. extra-axial lesion is a well-known systemic classification but has not been applied into clinical practice since there is no evidence-based support for its prognostic value. Hypothesis: Axial injury is related to worse functional independence compared to extra-axial injury at admission to and discharge from acute rehabilitation hospitalization. Design: Observational retrospective study. Settings and participants: Data from 71 participants who were enrolled at an acute rehabilitation hospital in the Northern California Traumatic Brain Injury Model System of Care (NCTBIMS) between 2005 and 2018 were included in the analysis. Main outcome measure and statistical analysis: Results of non-contrast head CT within the first 7 days after injury were analyzed to determine those with axial vs. extra-axial lesions. Functional Independence Measure (FIM) total scores were compared between the axial vs. extra-axial groups at admission and discharge using parametric and non-parametric tests. Results: There were no statistically significant group differences in FIM total scores at rehabilitation admission and discharge between the axial group and extra-axial groups. Conclusion: In this cohort of patients there was no evidence to support the hypothesis that axial injury is related to worse functional independence compared to extra-axial injury at rehabilitation admission and discharge. Utilizing MRI findings or other outcome measures, such as the 10 meter ambulation test or cognitive tests, may provide better sensitivity to potential functional differences.
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spelling pubmed-68381322019-11-15 The Prognosis of Axial vs. Extra-Axial Lesions on Functional Status After Traumatic Brain Injury Quach, Nhung Do, Jacqueline Dirlikov, Benjamin Ehsanian, Reza Pasipanodya, Elizabeth C. Ali, Arshad Duong, Thao Front Neurol Neurology Background: Head computed tomography (CT) scans are widely used in acute head injury for medical triage and surgical decisions, yet there are contradictions on the prognostic value of different head CT classifications. The intra-axial (axial) lesion vs. extra-axial lesion is a well-known systemic classification but has not been applied into clinical practice since there is no evidence-based support for its prognostic value. Hypothesis: Axial injury is related to worse functional independence compared to extra-axial injury at admission to and discharge from acute rehabilitation hospitalization. Design: Observational retrospective study. Settings and participants: Data from 71 participants who were enrolled at an acute rehabilitation hospital in the Northern California Traumatic Brain Injury Model System of Care (NCTBIMS) between 2005 and 2018 were included in the analysis. Main outcome measure and statistical analysis: Results of non-contrast head CT within the first 7 days after injury were analyzed to determine those with axial vs. extra-axial lesions. Functional Independence Measure (FIM) total scores were compared between the axial vs. extra-axial groups at admission and discharge using parametric and non-parametric tests. Results: There were no statistically significant group differences in FIM total scores at rehabilitation admission and discharge between the axial group and extra-axial groups. Conclusion: In this cohort of patients there was no evidence to support the hypothesis that axial injury is related to worse functional independence compared to extra-axial injury at rehabilitation admission and discharge. Utilizing MRI findings or other outcome measures, such as the 10 meter ambulation test or cognitive tests, may provide better sensitivity to potential functional differences. Frontiers Media S.A. 2019-11-01 /pmc/articles/PMC6838132/ /pubmed/31736869 http://dx.doi.org/10.3389/fneur.2019.01167 Text en Copyright © 2019 Quach, Do, Dirlikov, Ehsanian, Pasipanodya, Ali and Duong. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Quach, Nhung
Do, Jacqueline
Dirlikov, Benjamin
Ehsanian, Reza
Pasipanodya, Elizabeth C.
Ali, Arshad
Duong, Thao
The Prognosis of Axial vs. Extra-Axial Lesions on Functional Status After Traumatic Brain Injury
title The Prognosis of Axial vs. Extra-Axial Lesions on Functional Status After Traumatic Brain Injury
title_full The Prognosis of Axial vs. Extra-Axial Lesions on Functional Status After Traumatic Brain Injury
title_fullStr The Prognosis of Axial vs. Extra-Axial Lesions on Functional Status After Traumatic Brain Injury
title_full_unstemmed The Prognosis of Axial vs. Extra-Axial Lesions on Functional Status After Traumatic Brain Injury
title_short The Prognosis of Axial vs. Extra-Axial Lesions on Functional Status After Traumatic Brain Injury
title_sort prognosis of axial vs. extra-axial lesions on functional status after traumatic brain injury
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838132/
https://www.ncbi.nlm.nih.gov/pubmed/31736869
http://dx.doi.org/10.3389/fneur.2019.01167
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