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Relationship between hypertension on admission, cerebral edema, and post-traumatic headache in mild traumatic brain injury

Abstract

Introduction: Traumatic brain injury (TBI) is a common disorder in neurosurgery. TBI is classified based on the level of consciousness of the patient using the Glasgow Coma Scale. Hypertension at initial assessment can be harmful or beneficial to the patient due to the immediate compensatory mechanism for TBI. Abnormality of the brain should be measured using a non-contrast computed tomography (CT) scan of the head. TBI is often accompanied by cerebral edema and intracranial hemorrhage. Cerebral edema and intracranial hemorrhage may increase the volume of the brain resulting in decreased perfusion of blood to the brain. Furthermore, it can generate signs, symptoms, and complications of TBI. Post-traumatic headache (PTH) is a common secondary headache developed after TBI.

Methods: This research was an analytic descriptive study using a cross-sectional design from secondary data using patient medical records. The subject of the study was patients admitted to the hospital from 2019 to 2022 with mild TBI as the diagnosis. The blood pressure value was taken from the triage data. Blood pressure with systolic pressure of more than 139 mmHg or/and diastolic pressure of more than 89 were defined as hypertension. Cerebral edema and intracranial hemorrhage were observed from head CT scan imaging. Statistical analysis was conducted to observe the relationship between hypertension on admission, cerebral edema, and intracranial hemorrhage with PTH incidence in mild TBI patients.

Results: A total of 76 mild TBI patients, consisting of 46 males and 30 females were included. Most subjects were 30 – 59 years old (47.4%). The most common cause of TBI was traffic accidents consisting of 46 subjects. Twenty-three subjects met the criteria for hypertension and 53 subjects did not meet the criteria. Cerebral edema was found in 25 subjects (32.9%), while intracranial hemorrhage was found in 8 subjects (10.5%). Incidence of PTH reached 38.2% (29 subjects). Statistical analyses showed an association between cerebral edema (p = 0.025) and intracranial hemorrhage (p = 0.0002) with the occurrence of PTH. However, hypertension (p = 0.69) was not related to the occurrence of PTH.

Conclusion: Cerebral edema and intracranial hemorrhage have a significant relationship with the incidence of PTH in mild TBI. While the relationship between hypertension on admission and PTH is not significant statistically.

Keywords: cerebral edema, hypertension, intracranial hemorrhage, post-traumatic headache, traumatic brain injury

How to Cite

Husodo, K. R., & Suryonurafif, A. (2023). Relationship between hypertension on admission, cerebral edema, and post-traumatic headache in mild traumatic brain injury. Indonesian Journal of Neurosurgery, 6(3), 65–70. https://doi.org/10.15562/ijn.v6i3.251

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Kharisma Ridho Husodo
Google Scholar
Pubmed
IJN Journal


Akhmad Suryonurafif
Google Scholar
Pubmed
IJN Journal