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Head-injured adult patients with GCS of 3 on admission — Who have a chance to survive?

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Summary

The authors analysed a series of 111 adult patients admitted to the Department of Neurosurgery, Medical University of Łódź directly after trauma with initial GCS of 3 points. 74% of them had intracranial haematoma, mainly subdural, and were treated surgically within the first 3 hours after trauma. 8 patients had no abnormalities on CT scans.

99 (89%) patients died 2 to 30 days after injury, 8 (7%) survived in a vegetative state, and only in 4 (4%) was a satisfactory result noted, but 2 of them had a stable neurological deficit. 3 of these 4 patients had epidural haematomas and 1 had not abnormalities on repeated CT examinations.

We conclude, that among patients with GCS of 3 on admission, only those without major CT abnormalities or with epidural haematoma have a chance of survival. Cases with cerebral leasions on the initial CT examination have an invariably bad prognosis. They could be taken into account as a potential organ donor from the very moment of admission, but only after cerebral circulatory arrest occured and brain death has been proved according to internationally accepted standarts.

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Authors and Affiliations

  1. Department of Neurosurgery, Medical University of Łódź High School of Medicine, Poland

    Z. Kotwica & J. K. Jakubowski

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  1. Z. Kotwica
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  2. J. K. Jakubowski
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Kotwica, Z., Jakubowski, J.K. Head-injured adult patients with GCS of 3 on admission — Who have a chance to survive?. Acta neurochir 133, 56–59 (1995). https://doi.org/10.1007/BF01404948

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