Improved Outcome as a Result of Recognition of Absent and Compressed Cisterns on Initial CT Scans

The identification of absent or compressed basal cisterns on CT scans obtained after closed head injury has been shown to be related both to mortality and to the subequent development of elevated intracranial pressure (Murphy et al. 1983, van Dongen et al. 1983, Toutant et al. 1984). One of these studies (Toutant et al. 1984) was performed using data acquired from the pilot phase of the Traumatic Coma Data Bank. Recently, the main phase of this study has been completed and the data is undergoing initial analyses. We felt it would be of interest to compare the relationship of the findings of absent or compressed cisterns on initial CT scans to outcome in this larger group of patients and hypothesized that the information gained from the pilot study suggesting that recognition and aggressive management of patients with this radiographic finding would result in improved outcome.