Traumatic brain injury

외상성 뇌손상(traumatic brain injury, TBI)

진단

• mild(GCS=15)한 경우 brain CT indication
  • headache, vomiting, age >60 years, drug or alcohol intoxication, persistent anterograde amnesia, or visible trauma above the clavicle
• 기타 focal neurologic deficit, coagulopathy, scalp hematoma 등 고려

종류

• Intracranial hemorrhage: ICH, extraaxial hemorrhage; SDH, EDH, SAH
  • Acute hemorrhage의 경우 55~100HU, 1.5HU/day씩 attenuation 감소
  • Swirl sign
• Intraaxial injury
  • cerebral contusion
  • diffuse axonal inury(DAI); subcortical WM, corpus callosum, dorsolateral brain stem.
• vascular injury: CCF
• brain herniation: may cause secondary infarction, hydrocephalus and/or hemorrhage.
  • subfalcine herniation(m/c): ACA compression
  • transtentorial herniation: PCA compression, 3rd nerve palsy, midbrain and pons hemorrhage
  • tonsilar, external herniation.

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