We assume that an early iterative automatic CT scan analysis (D0, D1 and D3) by different AI approaches will allow an early differentiation of the tissues evolution after TBI. Our objective is to couple theses scan profiles to a neurological evolution, measured by therapeutic intensity.
Traumatic brain injury is a common and serious pathology, responsible of an important morbi-mortality. The TBI can be consider as a complex set of nosological entities of different evolution with difficult early identification whereas the main issue of this pathology depends on prevention and management of the lesions caused by the initial cerebral aggression. Different evolutionary profiles seems to exist and sometimes coexists: edema evolution, hemorrhagic transformation and/or cerebrospinal fluid (CSF) resorption issues with hydrocephalus apparition. Currently, there is no Imaging methods that can be used in every day clinical management that allows a visualization, quantification and prediction of these different lesional evolutions CT scan is the reference imaging method for TBI patient monitoring. It allows a lesion description, a therapeutic adaptation and an evaluation of the prognostic. Even if it is used as a routine examination, the analysis of cerebral scanners remains manual and a non-quantitative one, which make a little informative analysis as far as lesions evolution is concerned. Recently it has been established the automatic MRI analysis with AI approach allows: 1. \- To show aspects of images that can't be seen to the naked eye 2. \- To automatically segment and quantify the different tissues (edema, hemorrhage...). First tests on this kind of analysis on CT scans shows that this technology can be transferred from MRI to CT scans and more importantly it brings out new quantitative informations on cerebral lesions evolution.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
30
3 ct scans : D0, D1 and D3
University Hospital Grenoble
Grenoble, France
Clinical evolution during first 7 days in ICU with therapeutic intensity level (TILsum)
Composite criteria : Head position, depth, sort and objective of sedation, presence or absence of a CSF draining system, management of ventilation, presence or absence of a hyperosmolar therapy, management of body temperature, surgical intervention for intracranial hypertension.
Time frame: 7 days after TBI
Mortality according to scan profiles
Time frame: 28 days after TBI and 6 month after TBI
Morbidity (consequences of the trauma) according to scan profiles
Lenght of stay in ICU with more than 20 mmHg of intracranial pressure with no stimulation
Time frame: 28 days after TBI
Morbidity (consequences of the trauma) according to scan profiles
length of stay in ICU with a therapeutic intensity level \> or = 8,
Time frame: 28 days after TBI
Morbidity (consequences of the trauma) according to scan profiles
Hospital stay length
Time frame: 28 days after TBI
Morbidity (consequences of the trauma) according to scan profiles
ICU stay length days with mechanical ventilation
Time frame: 28 days after TBI
Morbidity (consequences of the trauma) according to scan profiles
Glasgow Outcome Scale (GOSe)
Time frame: 6 months after TBI
Comparison and Description of correlation between early scan profiles evolution signature by AI and to clinical evolution (with TILSum)
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Analysis of main outcome (TIL sum after 7 days in ICU maximum) according to a kinetic scan evolution between D0, D1 and D3
Time frame: 7 days after TBI
Neurological Pupil Index
Measure of neurological pupilla index within 1h after admission and at D1
Time frame: 1 day after TBI