Late computed tomography in survivors of severe head injury.

Ninety-seven of a consecutive series of 225 head-injured patients who were in coma for at least 6 hours survived for 12 months or more. Seventy-nine underwent computed tomography (CT) 1 to 4 years after the injury. Ct findings such as infratentorial and focal and diffuse supratentorial atrophy were correlated with overall social outcome, persistent neurological deficit, operations, and prognostic features. Coma lasting longer than 24 hours, ataxia, and severe disability show a high correlation with infratentorial atrophy, alone or in combination with supratentorial atrophy. Patients who came out of coma within 24 hours after injury and those who ultimately recovered well usually had a normal CT scan or focal supratentorial atrophy only. Most patients who had undergone operation for space-occupying extra- or intradural hematomas or contusions had focal atrophy on the operated side.