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Volume 6, Issue 6 (Suppl)
OMICS J Radiol, an open access journal
ISSN: 2167-7964
Neuroradiology 2017
October 30 to November 01, 2017
October 30 to November 01, 2017 | San Antonio, USA
2
nd
International Conference on
Neuroscience, Neuroimaging & Interventional Radiology
The cause of coma as identified with magnetic resonance imaging
Introduction:
Diffuse axonal injuries have been considered the most severe form of brain injury, which causes coma. To the
best of our knowledge there is no systematic study on magnetic resonance imaging (MRI) of the brain of patients in coma and
acute signs of herniation.
Patients &Methods:
A prospective series of 157 patients in posttraumatic coma for a minimum of 24 h was analyzed. Magnetic
resonance imaging of brain lesions was obtained within 10 days – median 2 days – of the injury with a 1.5 tesla magnet.
Statistical analysis including contingency tables, Fisher’s exact test, cross tables and odd ratios to investigate the correlation
of coma and eventually loss of pupil function and extension response with the locations of brain lesions on MRI and with
outcome.
Results:
63% of all patients in coma exhibited a brain stem lesion. All patients emerging from coma later one week after the
injury had a brain stem lesion. Duration of coma was highly statistically related with a brainstem lesion. Patients with either
unilateral loss of pupil function or extension response were statistically significantly more likely to harbor MRI lesions of the
brain stem when compared with patients in coma without further neurological deficits (p=0.0004 Fisher’s test). The correlation
of brainstem lesions with outcome according to the GOS after one year was highly significant (p<0.0001 Fisher’s test).
Conclusion:
Contrary to earlier concepts of diffuse axonal injury this is the first study giving evidence that brain stem lesions
play a pivotal role after head injury. The predictive value of MRI is higher than that of any other investigation.
Biography
Raimund Firsching LRCP (LOND.) MRCS (ENGL.) was born Dec. 12th 1953 born in Bochum, West Germany. 1972 beginning studies at medical school of the
University of Bonn, 1979, graduation from medical school Bonn, dissertation. 1980, conjoint exam in London, Queen Square, on the register of the General Medical
Council, United Kingdom. 1981 beginning neurosurgical training at the University of Cologne, 1986 research fellow at the University of Texas, Health Science
Center at San Antonio, Texas, USA, division of neurosurgery, chief: Dr. Story 1987 board certified neurosurgeon at the University of Cologne, Germany, 1988 ha-
bilitation for the field of neurosurgery, admitted to the Medical Faculty of the University of Cologne. 1992-1994 Vice chairman of the Department of Neurosurgery
at the Ruhruniversitaet in Bochum. 1995 until now Neurosurgeon-in-Chief and Professor at the Universitaetsklinik fuer Neurochirurgie Magdeburg. 1997 until 2013
nominated honorary judge of the state professional court of Magdeburg, capital of the state of Saxony Anhalt, Germany. 2017 congress president of the Deutsche
Gesellschaft fuer Neurochirurgie at the national convention of neurosurgery in Magdeburg Married to Dr. Ibsen-Firsching, a pediatrician, since 1981, 3 children.
raimund.firsching@med.ovgu.deRaimund Firsching
University Clinic for Neurosurgery, Germany
Raimund Firsching, OMICS J Radiol 2017, 6:6, (Suppl)
DOI: 10.4172/2167-7964-C1-017