A Design for Evaluation of the Trauma Apportionment in Cerebral Infarction after Trauma

作者：Kim Tae Hoon; Lee Kyeong Seok^*; Park Hae Ran; Shim Jae Joon; Yoon Seok Mann; Doh Jae Won

来源：Journal of Korean Neurosurgical Society, 2015, 57(1): 19-22.

DOI：10.3340/jkns.2015.57.1.19

• Cerebral infarction
• Causality
• Compensation and redress
• Craniocerebral trauma

Objective : Posttraumatic cerebral infarction (Cl) is a well-known complication of traumatic brain injury (TBI). However, the causation and apportionment of trauma in patients with Cl after TBI is not easy. There is a scoring method, so-called trauma apportionment score (TAS) for Cl, consisted with the age, the interval, and the severity of the TBI. We evaluated the reliability of this score.
Methods : We selected two typical cases of traumatic Cl. We also selected consecutive 50 patients due to spontaneous Cl. We calculated TAS in both patients with traumatic and spontaneous Cl. To enhance the reliability, we revised TAS (rTAS) adding three more items, such as systemic illness, bad health habits, and doctor's opinion. We also calculated rTAS in the same patients.
Results : Even in 50 patients with spontaneous Cl, the TAS was 4 in 44 patients, and 5 in 6 patients. TAS could not assess the apportionment of trauma efficiently. We recalculated the rTAS. in the same patients. The rTAS was not more than 11 in more than 70% of the spontaneous Cl. Compared to TAS, rTAS definitely enhanced the discriminating ability. However, there were still significant overlapping areas.
Conclusion : TAS alone is insufficient to differentiate the cause or apportionment of trauma in some obscure cases of Cl. Although the rTAS may enhance the reliability, it also should be used with cautions.

• 出版日期2015-1