CORRELATION OF MIDLINE SHIFT ON CT WITH GLASGOW COMA PUPILS SCORE (GCS-P) IN PREDICTING PROGNOSIS IN CRANIO-CEREBRAL TRAUMA

Abstract

Background and aim: Traumatic brain injuries are the known cause of mortality, morbidity, disability and socioeconomic losses worldwide especially in subjects above the age of 18yrs.It is important to assess and grade the Traumatic brain injury as soon as possible to guide management and decrease the comorbidities. Various guidelines have been issued by the neurosurgical societies to immediately assess and intervene when ever required. In this study, we have tried to assess the correlation of midline shift on CT with Glasgow Coma Scale Pupils Score (GCS-P) in predicting prognosis and management of head injury patients, and hence tried to simplify the prognostication process and improve the patient management. Methods: Hospital based prospective study was done on 100 patients who were referred to the Radiology department , SHRI B.M.PATIL MEDICAL COLLEGE for the duration between January 2021 to June 2022.Clinical data were gathered, including age, gender, the mechanism of the head injury, the Glasgow Coma Scale, pupil reactivity, and the clinical outcome along with CT findings mainly midline shift. Severity of head injury is classified as mild (GCS=15), moderate (GCS=13-14), severe (GCS=3-12). Results: 10 individuals had no midline shift on the brain's CT scan, 55 had shifts under 5 mm, and 35 had shifts greater than or equal to 5 mm. 33% of cases had mild GCS, 29 % had moderate GCS and 38 % had severe GCS.63% of cases had bilaterally equal reacting pupils, 22% had bilaterally unequal pupil and 15% had bilateral non reacting pupils. Among 100 cases, 80 % of cases had good outcome and 20% had poor outcome. There was significant correlation between the Midline shift and GCS severity. Conclusions: The severity of the brain injury was directly correlated with the degree of midline shift. Degree of midline shift was significantly related to the GCSP scores