Analysis of Geometric Relation between Cerebral Contusion and Site of Impact in Traumatic Brain Injury Patients

Amira Puti Karima, Muhammad Kusdiansah, Ahmad Faried, Muhammad Z. Arifin

Abstract


Cerebral contusion is found in 17–34% of traumatic brain injury (TBI) cases. The inertial and contact effects responsible for this injury makes the presence and location of contusion almost impossible to detect without appropriate imaging techniques. This study aimed to identify the geometric association between site of impact and cerebral contusion in patients with TBI. Data were collected retrospectively from Dr. Hasan Sadikin Hospital Bandung, Indonesia from January 2016–December 2017. TBI patients were scanned for diagnosis of cerebral contusion on the initial CT scan and the presence of soft tissue swelling as the site of impact. The locations were then geometrically classified into four groups; frontal, right temporoparietal, left temporoparietal, and occipital. Analysis was then performed using the multinomial logistic regression method with α=0.05 and 95% confidence interval (CI). Right temporoparietal contusion was associated with contrecoup impact compared to frontal impact (p=0.008, OR 6.8, 95% CI: 1.6–28.7) and occipital impact (p=0.002, OR 6.8, 95% CI: 1.7–26.8) while left temporoparietal contusion was associated with contrecoup impact compared to frontal (p=0.006, OR 6.8, 95% CI: 1.7–26.8) and occipital impact (p=0.016, OR 10, 95% CI: 1.3-17) and with coup impacts compared to frontal impacts (p=0.025, OR 5.3, 95% CI: 1.2–23.3). It is concluded that temporal contusion has a statistically significant correlation with contrecoup impacts.

 

Hubungan Analisis Geometris antara Kontusi Serebral dan Lokasi Benturan pada Pasien Cedera Otak Traumatis

Kontusi serebral ditemukan pada 17–34% kasus cedera otak traumatika (TBI). Efek inersia dan kontak yang bertanggung jawab untuk cedera ini membuat keberadaan dan lokasi benturan hampir mustahil untuk dideteksi tanpa teknik pencitraan yang tepat. Penelitian ini bertujuan untuk menemukan hubungan geometris antara kontusi serebral dan lokasi benturan yang terjadi pada pasien TBI. Data dikumpulkan secara retrospektif dari Rumah Sakit Dr. Hasan Sadikin Bandung, dari Januari 2016–Desember 2017. Pasien TBI dipindai untuk diagnosis kontusio serebral menggunakan CT scan awal dan adanya pembengkakan jaringan lunak sebagai tempat terjadinya benturan. Lokasi itu kemudian secara geometris diklasifikasikan menjadi empat kelompok; frontal, temporoparietal kanan, temporoparietal kiri, dan oksipital, kemudian dianalisis menggunakan metode regresi logistik multinomial dengan α=0,05 dan interval kepercayaan (IK) 95%. Kontusio temporoparietal kanan dikaitkan dengan impact contrecoup dibanding dengan impact frontal (p=0,008, OR 6,8, IK 95% 1,6–28,7) dan impact oksipital (p=0,002, OR 6,8, IK 95% 1,7–26,8), sementara kontusi temporoparietal kiri dikaitkan dengan impact contrecoup dibandingkan dengan impact frontal (p=0,006, OR 6,8, IK 95% 1,7–26,8) dan impact oksipital (p=0,016, OR 10, IK 95% 1,3–17) dan dengan impact coup dibanding dengan impact frontal (p=0,025, OR 5,3, IK 95% 1.2–23.3). Simpulan, bahwa kontusio temporal memiliki korelasi yang signifikan secara statistik dengan impact contrecoup.


Keywords


Cerebral Contusion, Computed Tomography, Impact Injury, Traumatic Brain Injury

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DOI: https://doi.org/10.15395/mkb.v51n4.1498

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