Radioisotope cisternography in head-injured patients.

Of 600 patients submitted to radioisotope cisternography carried out with radioiodinated human serum albumin (I131-HSA) a group of 140 had head injuries. Our investigation was intended to study the modifications of CSF circulation and absorption which accompany cranio-cerebral trauma. Of 88 head injured patients who did not undergo operation 44 had transient loss of consciouness, and 44 were in prolonged coma. Fifty-two patients underwent operation. Of these 5 had skull fractures with dural lesions, 7 had extradural haematomas, 19 had subdural haematomas, and 21 had brain contusions. Cisternograms were performed at different time intervals after trauma, and in some instances the test was repeated in order to study the possible long tern alterations of CSF circulation and absorption. Abnormalities of cisternographic pictures are classified into the following groups: 1 degree asymmetric diffusion; 2 degree operative cavity stagnation; 3 degree ventricular reflux; 4 degree associated abnormalities. Cisternographic features are analysed in relation to the corresponding clinical and pneumoencephalographic patterns in the patients examined. These investigations may enable us to recognise possible indications for shunt procedures in the management of CSF absorption defects, which are so frequently apparent after head injury.