Causality relationship between Hounsfield Unit in epidural hematoma and subdural hematoma and hematoma expansion

Gunna Hutomo Putra; Agus Turchan; Sri Andreani Utomo; Muhammad Arifin Parenrengi; Asra Al Fauzi; Arief Wibowo

doi:10.15562/bmj.v12i2.4114

Causality relationship between Hounsfield Unit in epidural hematoma and subdural hematoma and hematoma expansion

Gunna Hutomo Putra ,

Agus Turchan ,

Sri Andreani Utomo ,

Muhammad Arifin Parenrengi ,

Asra Al Fauzi ,

Arief Wibowo ,

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DOI: https://doi.org/10.15562/bmj.v12i2.4114 |
Published: 2023-05-09

Abstract

Background: Traumatic brain injury (TBI) is damage to the head caused by an external physical attack/impact. Deaths that occur from brain injury are 14-30 out of 100,000 population each year. TBI is diagnosed using Computed Tomography (CT) as the gold standard. Different densities of the pathological feature on CT can be measured by Hounsfield Unit (HU) to define its pathology. We try to asses if the HU can predict the hematoma expansion in TBI.

Methods: This research is an observational study. The data is taken from the radiology installation data of the emergency care installation at the Dr. Soetomo Regional General Hospital regarding factors that play a role in hematoma expansion with related factors in patients with subdural and epidural bleeding. Data were taken from January 2021 to December 2021. The factors analyzed were Hounsfield Unit, age, and hemostasis factors.

Results: In this study, there were 30 patients. This study was dominated by men (73.00%) and the age group of 16-20 years (26.6%). The mean PTT value in this study's subjects was 13.3±3.27. The mean value of APTT is 29.8±2.82. The average Hounsfield Unit is 43.60±5.82. No significant relationship was found between Houndsfield Unit, Age, APTT level, and age with hematoma expansion. A significant relationship was found between PTT and hematoma expansion. Simultaneously Hounsfield Unit, PTT, APTT, and age had a significant relationship with hematoma expansion.

Conclusion: There was no statistically significant relationship between Hounsfield Unit and hematoma expansion. There is a statistically significant relationship between PTT and hematoma expansion. Simultaneously found a significant relationship between Hounsfield Unit, PTT, APTT, age, and bleeding activity.

References

Algattas H, Huang JH. Traumatic Brain Injury pathophysiology and treatments: Early, intermediate, and late phases post-injury. Int J Mol Sci. 2013;15(1):309–341.
Parizel PM, Makkat S, Van Miert E, Van Goethem JW, van den Hauwe L, De Schepper AM. Intracranial hemorrhage: principles of CT and MRI interpretation. Eur Radiol. 2001;11(9):1770-1783.
Corrigan JD, Selassie AW, Orman JA. The Epidemiology of Traumatic Brain Injury. Journal of Head Trauma Rehabilitation. 2010;25(2):72–80.
Kong SY, Ro YS, Shin S Do, Song KJ, Park JH. Epidemiology of traumatic brain injury in the Republic of Korea from 2011 to 2014: based on three major data sources in the Republic of Korea. Journal of EMS Medicine. 2022;1(1):13-22.
Aromatario M, Torsello A, D’errico S, Bertozzi G, Sessa F, Cipolloni L, et al. Traumatic epidural and subdural hematoma: Epidemiology, outcome, and dating. Medicina (Lithuania). 2021:57(2):125.
Niryana IW, Junior IWJ, Darmawan R, Widyadharma IPE. Characteristics of Traumatic Brain Injury in Sanglah Hospital, Bali, Indonesia: A Retrospective Study. Biomedical and Pharmacology Journal. 2020;13(03):1431–1437.
Brazinova A, Rehorcikova V, Taylor MS, Buckova V, Majdan M, Psota M, et al. Epidemiology of Traumatic Brain Injury in Europe: A Living Systematic Review. J Neurotrauma. 2021;38(10):1411–1440.
McKinlay A, Grace RC, Horwood LJ, Fergusson DM, Ridder EM, MacFarlane MR. Prevalence of traumatic brain injury among children, adolescents and young adults: Prospective evidence from a birth cohort. Brain Inj. 2008;22(2):175–181.
Asih MW, Puspita NPPT. Predictor scale of delayed cerebral ischemic in aneurysmal subarachnoid hemorrhage case series: what a radiologist should know. Indonesia Journal of Biomedical Science. 2020;14(2):99–103.
Irie F, Le Brocque R, Kenardy J, Bellamy N, Tetsworth K, Pollard C. Epidemiology of traumatic epidural hematoma in young age. J Trauma. 2011;71(4):847–853.
Ordookhanian C, Kaloostian PE. Trauma-induced Acute Epidural Hematoma: The Rising Sun in a Progressively Lethargic Man. Cureus. 2018;10(8):p.e3162.
Hoyt DB. A clinical review of bleeding dilemmas in trauma. Semin Hematol. 2004;41(1):40–43.
Maegele M, Schöchl H, Menovsky T, Maréchal H, Marklund N, Buki A, et al. Coagulopathy and haemorrhagic progression in traumatic brain injury: advances in mechanisms, diagnosis, and management. Lancet Neurol. 2017;16(8):630–647.
Kim NY, Lim J, Lee S, Kim K, Hong JH, Chun DH. Hematological factors predicting mortality in patients with traumatic epidural or subdural hematoma undergoing emergency surgical evacuation: A retrospective cohort study. Medicine. 2020;99(37):e22074.
Risfandi M, Musyari S, Celia C. Acute subdural hemorrhage accompanied with rupture of the inferior vena cava: a case report. Bali Medical Journal. 2021;10(2):507–509.
Golden N, Mardhika PE, Niryana W, Sukarya IM, Prabawa IPY. Risk factors and novel prognostic score for predicting the 14-day mortality of severe traumatic brain injury patients. Intisari Sains Medis. 2020;11(3):1020-1028.

[1] Algattas H, Huang JH. Traumatic Brain Injury pathophysiology and treatments: Early, intermediate, and late phases post-injury. Int J Mol Sci. 2013;15(1):309–341.

[2] Parizel PM, Makkat S, Van Miert E, Van Goethem JW, van den Hauwe L, De Schepper AM. Intracranial hemorrhage: principles of CT and MRI interpretation. Eur Radiol. 2001;11(9):1770-1783.

[3] Corrigan JD, Selassie AW, Orman JA. The Epidemiology of Traumatic Brain Injury. Journal of Head Trauma Rehabilitation. 2010;25(2):72–80.

[4] Kong SY, Ro YS, Shin S Do, Song KJ, Park JH. Epidemiology of traumatic brain injury in the Republic of Korea from 2011 to 2014: based on three major data sources in the Republic of Korea. Journal of EMS Medicine. 2022;1(1):13-22.

[5] Aromatario M, Torsello A, D’errico S, Bertozzi G, Sessa F, Cipolloni L, et al. Traumatic epidural and subdural hematoma: Epidemiology, outcome, and dating. Medicina (Lithuania). 2021:57(2):125.

[6] Niryana IW, Junior IWJ, Darmawan R, Widyadharma IPE. Characteristics of Traumatic Brain Injury in Sanglah Hospital, Bali, Indonesia: A Retrospective Study. Biomedical and Pharmacology Journal. 2020;13(03):1431–1437.

[7] Brazinova A, Rehorcikova V, Taylor MS, Buckova V, Majdan M, Psota M, et al. Epidemiology of Traumatic Brain Injury in Europe: A Living Systematic Review. J Neurotrauma. 2021;38(10):1411–1440.

[8] McKinlay A, Grace RC, Horwood LJ, Fergusson DM, Ridder EM, MacFarlane MR. Prevalence of traumatic brain injury among children, adolescents and young adults: Prospective evidence from a birth cohort. Brain Inj. 2008;22(2):175–181.

[9] Asih MW, Puspita NPPT. Predictor scale of delayed cerebral ischemic in aneurysmal subarachnoid hemorrhage case series: what a radiologist should know. Indonesia Journal of Biomedical Science. 2020;14(2):99–103.

[10] Irie F, Le Brocque R, Kenardy J, Bellamy N, Tetsworth K, Pollard C. Epidemiology of traumatic epidural hematoma in young age. J Trauma. 2011;71(4):847–853.

[11] Ordookhanian C, Kaloostian PE. Trauma-induced Acute Epidural Hematoma: The Rising Sun in a Progressively Lethargic Man. Cureus. 2018;10(8):p.e3162.

[12] Hoyt DB. A clinical review of bleeding dilemmas in trauma. Semin Hematol. 2004;41(1):40–43.

[13] Maegele M, Schöchl H, Menovsky T, Maréchal H, Marklund N, Buki A, et al. Coagulopathy and haemorrhagic progression in traumatic brain injury: advances in mechanisms, diagnosis, and management. Lancet Neurol. 2017;16(8):630–647.

[14] Kim NY, Lim J, Lee S, Kim K, Hong JH, Chun DH. Hematological factors predicting mortality in patients with traumatic epidural or subdural hematoma undergoing emergency surgical evacuation: A retrospective cohort study. Medicine. 2020;99(37):e22074.

[15] Risfandi M, Musyari S, Celia C. Acute subdural hemorrhage accompanied with rupture of the inferior vena cava: a case report. Bali Medical Journal. 2021;10(2):507–509.

[16] Golden N, Mardhika PE, Niryana W, Sukarya IM, Prabawa IPY. Risk factors and novel prognostic score for predicting the 14-day mortality of severe traumatic brain injury patients. Intisari Sains Medis. 2020;11(3):1020-1028.

Causality relationship between Hounsfield Unit in epidural hematoma and subdural hematoma and hematoma expansion

Abstract

References

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