Leukocytosis: Predictor of Radiological and Neurological Outcome of Patients of Traumatic Brain Injury Presented to Jinnah Hospital, Lahore

  • SYED SHAHZAD HUSSAIN Department of Neurosurgery, Jinnah Hospital, Lahore
  • USMAN AHMAD KAMBOH Department of Neurosurgery, Jinnah Hospital, Lahore
  • ASIF RAZA Department of Neurosurgery, Jinnah Hospital, Lahore
  • ABDUL HAFEEZ Department of Neurosurgery, Jinnah Hospital, Lahore
  • SAMAN SHAHID Department of Sciences & Humanities, National University of Computer & Emerging Sciences
  • NAVEED ASHRAF Department of Neurosurgery, Jinnah Hospital, Lahore
Keywords: Traumatic brain injury, Total leukocyte count, Extradural hematoma, Subdural hematoma, Traumatic subarachnoid hemorrhage, White blood cells, Glasgow outcome scale extended

Abstract

Background/Objective: Catecholamines and cortisol cause raised TLC (total leukocyte count) and brain inflammation after injury. We found out that weather leukocytosis is predictive for radiological and neurological outcome in patientswith TBI presenting to JHL.
Materials and Methods: Blood samples of patients (n = 100) were collected on presentation in the emergency room, after 72 hours and on the 5th day for TLC count.CT Brain was obtained on presentation in emergency, after 72 hours and on the 5th day. The progression of imaging findings on CT scan were assessed and compared with TLC count. The outcome of these patients was assessed according to the Extended Glasgow Outcome Scale.
Results: TLC after TBI is raised initially and then it declined afterwards in mild and moderate TBI, but remained on the upper limit in moderate TBI. In severe TBI, TLC was raised initially and then it progressed to higher limits afterwards.These results showed that there is a strong relation between TLC and TBI.Regarding the association between radiological assessment and severity of injury along with raised TLC, it was observed that the patients having EDH had raised TLC along with expansion of hematoma, while patients with contusions, T-SAH (traumatic sub-dural hematoma) SDH had TLC on upper limit, but there was no significant resolution of radiological severity
Conclusion: WBC count can be used as a predictor of radiological outcome, as it was found that patients with severe head injury had raised TLC. TLC count can be used to assess the severity of injury and prognosis.

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Published
2019-12-29
Section
Original Article