# Evolution of Severe Closed Head Injury: Assessing Ventricular Volume and Behavioral Measures at 30 and 90 Days Post-Injury

## TL;DR

This study explores how brain ventricle volume changes over time in severe head injury patients and how these changes relate to behavioral outcomes.

## Contribution

The study introduces VBR as a novel metric for tracking brain atrophy and predicting functional outcomes in SCHI patients.

## Key findings

- VBR decreased in the acute phase and increased later, indicating brain atrophy.
- VBR showed stronger correlations with disability and rehabilitation scores at 90 days.
- VBR is a reliable early indicator of brain atrophy and functional outcomes.

## Abstract

Background: Assessing functional outcomes in Severe Closed Head Injury (SCHI) is complex due to brain parenchymal changes. This study examines the Ventricles to Intracranial Volume Ratio (VBR) as a metric for these changes and its correlation with behavioral scales. Methods: Thirty-one SCHI patients were included. VBR was derived from CT scans at 3, 30, and 90 days post-injury and compared with Levels of Cognitive Functioning (LCF), Disability Rating Scale (DRS), and Early Rehabilitation Barthel Index (ERBI) assessments at 30 and 90 days. Results: Ten patients were excluded post-decompressive craniectomy or ventriculoperitoneal shunt. Findings indicated a VBR decrease at 3 days, suggesting acute phase compression, followed by an increase from 30 to 90 days, indicative of post-acute brain atrophy. VBR correlated positively with the Marshall score in the initial 72 h, positioning it as an early indicator of subsequent brain atrophy. Nevertheless, in contrast to the Marshall score, VBR had stronger associations with DRS and ERBI at 90 days. Conclusions: VBR, alongside behavioral assessments, presents a robust framework for evaluating SCHI progression. It supports early functional outcome correlations informing therapeutic approaches. VBR’s reliability underscores its utility in neurorehabilitation for ongoing SCHI assessment and aiding clinical decisions.