The treatment of head traumas with different mannitol doses according to the size of perimesencephalic cisterns in computed tomography

Summary: Prognosis and mortality of head injury is assessed with clinical factors and radiological findings. These factors are age, etiology of trauma, multy-system trauma, pupil reactions, necessity of urgent airway, Glasgow Coma Scale (GCS) and obliteration of basal cisterns in cranial computed tomography.In this study, 50 adult head injuried patients who were over 17 years old, were divided into 3 groups according to size of perimesencephalic cisterns, as compressed (group 1), absent (group 2) and not visualized (group 3), and treated with 20% Mannitol in standart dose interval (0,25 ? 2 gr/kg/day iv).In the study, male sex, age between 18 ? 30 and, head injury caused by traffic accident rates were more than the others. Severe head injury (GCS 8-3) rate was high in group 3. (x2=6.1185 p<0.05)Different treatment doses in the range of 20% mannitol have been given to the compressed, absent and not visualized groups formed in according to size of perimesencephalic cisterns. All of this three different treatment doses have been had statistically significant increases at the 72 hours?s GCS. (Group 1 t= -4.440 p < 0.05) (Group 2 t= -2.867 p < 0.05) (Group 3 t= -3.372 p < 0.05).The better response was observed in group 1 with the low dose of 20 % mannitol with respect to GCS at the 72th hours.Key Words: Head injury, Mannitol, Basal cisterns, Prognosis