Relación entre variables clínicas sugestivas de hipertensión intracraneal y alteración en la neuroimagen en traumatismo craneoencefálico.

Abstract

Introduction: Acute cerebral injury (ACI), triggered by isolated traumatic brain injury (TBI) or in the context of multiple trauma, is one of the leading causes of death in young adults. It is believed that the increase in intracranial pressure, even momentary, compromises cerebral perfusion and causes cerebral ischemia. Methods: Retrospective, observational and analytical study. The data were extracted from the medical records of the Hospital Luis Vernaza (HLV) from September 2016 to September 2018. Results: We included a total of 297 patients with isolated TBI or in the context of a polytrauma admitted to the ICU of the HLV. The most common neuroimaging lesion was multiple injury (35.4%). Regarding the Marshall scale, category I was the most frequent. We found that there is a significant correlation between the presence of neuroimaging lesion and the presence of fixed pupils at admission (p = 0.000), the score ≤8 on the Glasgow scale (p = 0.000) and the need for orotracheal intubation (p = 0.000). ). In addition, we found that MAP <60 mmHg had statistical significance (p = 0.007) when related to the Marshall category ≥ III. Conclusion: In the present study it was found that the clinical variables: MAP <60, pupil fixation, need for endotracheal intubation and Glasgow ≤ 8 are related to the development of neuroimaging lesion in patients with TBI.