Prognostic value of the Marshall computed tomography classification for traumatic subarachnoid hemorrhage

Abstract Background: The Marshall computed tomography (CT) system for classification of traumatic brain injury (TBI) includes the most important independent prognostic variables except for traumatic subarachnoid hemorrhage (tSAH). Objectives: To evaluate the prognostic effect of tSAH on different injury types based on the Marshall CT system. Methods: We performed a retrospective study. All patients with severe closed head injury admitted from February 2011 to July 2012 were included. Their scans were classified into two groups: localized injury and diffuse injury using the Marshall classification. Outcomes were compared between patients with tSAH and those without tSAH among the two groups. Results: Ninety-six patients were included in this study. Seventy-two (75%) were found to have tSAH, and outcomes significantly negatively correlated with tSAH in both localized injury and diffused injury groups. Conclusions: tSAH had an important effect on the patients’ outcome. Although the Marshall classification includes important independent prognostic variables, tSAH should also be added.