CLINICAL-SIGNIFICANCE OF THE FINDING OF SUBARACHNOID BLOOD ON CT SCANAFTER HEAD-INJURY

The population analysed consisted of 268 out of 819 patients of a Euro pean nimodipine multicentre trial on severe head injury, whose first C T scan after injury showed signs of subarachnoid bleeding. The study d emonstrated the importance of traumatic subarachnoid haemorrhage (tSAH ) per se as a prognostic factor. The outcome of patients with tSAH is significantly worse than that of patients whose first CT does not show subarachnoid blood (noSAH). The outcome was unfavourable (dead, persi stent vegetative state, severe disability) in 60% of tSAH patients com pared to 30% of noSAH patients (p < 0.001). The difference in mortalit y was 42% vs. 14% (p < 0.001). The six month follow-up of tSAH patient s complying with the study protocol and treated with intravenous nimod ipine, 2 mg per hour for 7 days, showed a statistically significant re duction of unfavourable outcome from 66% to 51% (p < 0.05), compared t o placebo treated patients.