Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지
DOI QR코드

DOI QR Code

The Significance of Clinical Examination for Brain Lesion Differentiation of Patients with Head Trauma after Alcohol Intoxication

  • Jung, Yoon Hyun (Department of Emergency Medicine, College of Medicine, Soonchunhyang University) ;
  • Jeong, Dong Kil (Department of Emergency Medicine, College of Medicine, Soonchunhyang University) ;
  • Lee, Jung Won (Department of Emergency Medicine, College of Medicine, Soonchunhyang University) ;
  • Moon, Hyung Jun (Department of Emergency Medicine, College of Medicine, Soonchunhyang University) ;
  • Choi, Jae Hyung (Department of Emergency Medicine, College of Medicine, Soonchunhyang University) ;
  • Song, Jun Hwan (Department of Pediatrics, College of Medicine, Soonchunhyang University)
  • Received : 2016.08.14
  • Accepted : 2016.12.30
  • Published : 2016.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: There are many patients visited to ED in an alcohol intoxicated state. For these patients, it is difficult to predict by only clinical examination whether he/she would have brain lesion. The purpose of this study is to research whether it is possible to predict brain lesion by only clinical examination findings, with comparing patients with/without actual brain lesions. Methods: A retrospective study was performed at a university hospital for the period 11 months with the medical records. As for the inclusion group, head trauma patients with objectively proved drunk, judging by their blood ethanol concentration, and performed the brain CT were selected. In terms of medical record, Glasgow coma scale (GCS), the presence of neurologic abnormalities, the presence of lesion on brain CT of the patients, were examined. From laboratory results, blood ethanol concentration, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT) and glucose concentration were identified. Results: For this study, there were total 80 patients of inclusion group. There was no statistically significant difference in terms of GCS score and neurological examination abnormalities, between the group with brain lesion and the group without brain lesion on brain CT. Conclusion: Alcohol intoxicated patient with head trauma visits the ED, it is not possible to distinguish or determine whether brain lesion exists or not by only clinical findings. In order to check the lesion existence, the image examination, therefore, should be considered and performed.

Keywords

References

  1. SH Choi, CK Moon, JD Mun, SW Lee, YS Hong. Alcohol Related Trauma Patients. J Korean Soc Emerg Med 1999; 10: 266-75.
  2. H Noh, YH Choi, EK Eo, KY Jung. The Adequacy of Selfreporting and Physician's Diagnoses for Assessing Alcohol Ingestion in Trauma Patients. J Korean Soc Emerg Med 2007; 18: 307-12.
  3. Judith E. Tintinalli JSS, O. John Ma, Donald M. Yealy, Garth D. Meckler, David M. Cline. Tintinalli's Emergency Medicine. 8th ed. New York: McGraw-Hill Medicine; 2016. p1243.
  4. Teasdale G, Jennett B. Assessment and prognosis of coma after head injury. Acta neurochirurgica 1976; 34: 45-55. https://doi.org/10.1007/BF01405862
  5. Sporer KA, Solares M, Durant EJ, Wang W, Wu AH, Rodriguez RM. Accuracy of the initial diagnosis among patients with an acutely altered mental status. Emergency medicine journal: EMJ 2013; 30: 243-6. https://doi.org/10.1136/emermed-2011-200452
  6. Starke RM, Komotar RJ, Otten ML, Schmidt JM, Fernandez LD, Rincon F, et al. Predicting long-term outcome in poor grade aneurysmal subarachnoid haemorrhage patients utilising the Glasgow Coma Scale. Journal of Clinical Neuroscience 2009; 16: 26-31. https://doi.org/10.1016/j.jocn.2008.02.010
  7. SH Choi, JD Moon, SJ Kim, CK Moon, SW Lee, YS Hong. Prognostic Factors in Head Trauma Patients. J Korean Soc Emerg Med 2001; 12: 105-18.
  8. KH Kim, KH Lee, WY Kim, YC Yoon, HY Kim. Computed Tomography (CT) in Head Trauma Patients with Alert Mental Status: How Important are the Clinical Symptoms. J Korean Soc Emerg Med 1997; 8: 564-70.
  9. Ashkenazi I, Schecter WP, Peleg K, Givon A, Olsha O, Turegano-Fuentes F, et al. Glasgow Coma Scale Score in Survivors of Explosion With Possible Traumatic Brain Injury in Need of Neurosurgical Intervention. JAMA 2016.
  10. Sullivan SJ, Hammond-Tooke GD, Schneiders AG, Gray AR, McCrory P. The diagnostic accuracy of selected neurological tests. Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia 2012; 19: 423-7. https://doi.org/10.1016/j.jocn.2011.09.011