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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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CT scan | Experimental | During this study each patient will have 3 CT scans : D0, D1 and D3. A daily follow up during first seven days in ICU, then a follow up at D28 if still in hospital, and a phone call at M6 for neurological outcome |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CT scan | Radiation | 3 ct scans : D0, D1 and D3 |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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. | 7 days after TBI |
| Measure | Description | Time Frame |
|---|---|---|
| Mortality according to scan profiles | 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 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Pierre BOUZAT | University Hospital, Grenoble | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Grenoble | Grenoble | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37978266 | Derived | Brossard C, Greze J, de Busschere JA, Attye A, Richard M, Tornior FD, Acquitter C, Payen JF, Barbier EL, Bouzat P, Lemasson B. Prediction of therapeutic intensity level from automatic multiclass segmentation of traumatic brain injury lesions on CT-scans. Sci Rep. 2023 Nov 17;13(1):20155. doi: 10.1038/s41598-023-46945-9. |
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| ID | Term |
|---|---|
| D000070642 | Brain Injuries, Traumatic |
| ID | Term |
|---|---|
| D001930 | Brain Injuries |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| 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, | 28 days after TBI |
| Morbidity (consequences of the trauma) according to scan profiles | Hospital stay length | 28 days after TBI |
| Morbidity (consequences of the trauma) according to scan profiles | ICU stay length days with mechanical ventilation | 28 days after TBI |
| Morbidity (consequences of the trauma) according to scan profiles | Glasgow Outcome Scale (GOSe) | 6 months after TBI |
| Comparison and Description of correlation between early scan profiles evolution signature by AI and to clinical evolution (with TILSum) | Analysis of main outcome (TIL sum after 7 days in ICU maximum) according to a kinetic scan evolution between D0, D1 and D3 | 7 days after TBI |
| Neurological Pupil Index | Measure of neurological pupilla index within 1h after admission and at D1 | 1 day after TBI |
| D006259 |
| Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |