미만성축삭손상 환자의 임상고찰

Backgrounds : The objects of this study were to review various computerized tomography (CT) finding which might have been related to consciousness levels (GCS) and the outcomes of patients with diffuse axonal injury (DAI), and to provide some valuable guidelines for management. Methods : Sixty-one patients who showed so-called “diffuse axonal injury”on CT had been analyzed. We evaluated them retrospectively for 2 years from 1996 through 1997. The presence of small amount of intracranial hemorrhage, subarachnoid hemorrhage (SAH), generalized brain swelling (GBS), classification by modified Adams staging and skull fracture in the CT scan were reviewed and analyzed in conjunction with the outcome. Results : Traffic accident by automobile was most common cause of trauma (90.2%). Lesions of DAI were alomost found in the deep white matter of cerebral hemisphere, corpus callosum and basal ganglia, and brainstem. CT findings of GBS and SAH were associated with statistical-ly significant correlation with poor outcome, but small amount of intracranial hemorrhage and modified Admas staging did not correlat with outcome. Conclusion: DAI had been almost demonstrated in the patients with moderate and severe head injury, but it was also found in the mildly head-injured patients. Brainstem or corpus callo-sum and basal ganglia hemorrhage was not associated with an adverse outcome.