Risk factors of deterioration in patients with traumatic frontal contusions

Objective To explore the risk factors of deterioration in patients with different traumatic frontal contusions,and if patients at risk could be recognized at the time of initial CT. Methods The clinical data of 36 head injury patients in whom CT had shown frontal contusions without diffuse brain injury or intracranial hematoma were analyzed retrospectively. The type of frontal contusions( the first computed tomography after traumatic brain injury),Glasgow Coma Score on admission( GCS),the time of deterioration and prognosis( GOS) were analyzed. Results Of 36 patients,20 with unilateral frontal contusion made a good recovery,4 of 10 patients with limited bilateral frontal contusions made a good recovery. 4 of 6 patients with extensive bilateral frontal contusions deteriorated more than 24 hours after injury,and one died. Conclusions In particular,the delayed effects of brain edema is the main cause of the deterioration in patients with traumatic frontal contusions. The type of frontal contusions identified by the first computed tomography can be used to predict the risk of deterioration. Such risk is particularly high in patients with extensive bilateral frontal contusions.