A quantitative computed tomography assessment of brain weight, volume, and specific gravity in severe head trauma

Background: Computed tomography DICOM images analysis allows a quantitative measurement of organ weight, volume and specific gravity in humans. Methods: The brain weight, volume and specific gravity of 15 traumatic brain-injury patients (3 +/- 2 days after trauma) were computed using a specially designed software (BrainView). Data were compared with those obtained from 15 healthy subjects paired for age and overall intracranial volume. Results: Hemisphere weight were 91 g higher in patients than in controls (1167 +/- 101 vs 1076 +/- 112 g; p < 0.05). Specific gravity of hemispheres (1.0367 +/- 0.0017 vs 1.0335 +/- 0.0012 g/ml; p < 0.001), brainstem (1.0302 +/- 0.0016 vs 1.0277 +/- 0.0015 g/ml; p < 0.001) and cerebellum (1.0396 +/- 0.0020 vs 1.0375 +/- 0.0015 g/ml; p < 0.05) was significantly higher in traumatic brain injury (TBI) patients than in controls (all p < 0.0001 without interaction). This increase in specific gravity was evenly distributed between the hemispheres, the brainstem and the cerebellum, and the grey and white matter. It was more pronounced in the rostral than in the caudal areas of the hemispheres. It was independent of the volume of brain contusion, of the mechanism of head injury, of natremia and of initial Glasgow coma score. Conclusion: Human TBI patients present a diffuse increase in specific gravity. This observation is in sharp opposition with the data derived from the experimental literature.