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African Journal of Neurological Sciences
Pan African Association of Neurological Sciences
ISSN: 1015-8618
Vol. 16, No. 1, 1997
Bioline Code: ns97001
Full paper language: English
Document type: Research Article
Document available free of charge

African Journal of Neurological Sciences, Vol. 16, No. 1, 1997

 en Management of patients with severe head injuries

Abstract

Afri. J. Neuro. Sci. Vol. 16 No. 1 Jan 1997

MANAGEMENT OF PATIENTS WITH SEVERE HEAD INJURIES.

P.L. SEMPLE, N. FISHER-JEFFES

Department of Neurosurgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.

Code Number:NS97001

SUMMARY

Introduction

At Groote Schuur Hospital head injured patients are managed by the Neurosurgical Department. A retrospective study was undertaken to determine whether the intensive management of head injuries with a low Glasgow Coma Scale (GCS) on admission is justified. One hundred and five patients admitted during 1990 with a GCS of 8/15 or less were grouped on the basis of their GCS following resuscitation. Thirty four patients were admitted with a GCS of 3/15 and fifty two patients were admitted with GCS of 6/15-8/15. The outcome of these patients was then analyzed; the findings suggesting that those patients who have been adequately resuscitated, and have had an intracranical haematoma evacuated, but still present with a GCS 5/15 or less at 6 hours post injury have such a poor prognosis that high tech intensive care may not be justified.

RESUME

Au Groote Schuur Hospital, les traumatises craniens sont pris en charge par le Department de Neurochirurgie. Une crude retrospective a ete entreprise pour savoir si les soins intensifs etaient justifies pour les patients qui, a leur admission, presentaient un faible niveau de "Glasgow Coma Scale" (GCS); 105 patients hospitalises en 1990 avec un GCS egal ou inferiur a 8/15, etaient groupes en se basant sur leur GCS apres reanimation; 34 avaient un GCS de 3/15, 7 de 4/15, 12 de 5/15, et 52 de 6/15 a 8/15. Le devenir de ces patients a ete analyse. Il en resulte que les patients qui, malgre une reanimation correcte et une evacuation de leur haematome intra-cranien, avaient, encore six heures apres le traumatisme, un GCS egal ou inferieur a 5/15, le pronostic etait tellement mauvais que la pratique des soins intensifs de haute technicite ne semblait pas justifiee.

Copyright 1995 Pan African Association of Neurological Sciences

 

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