Secondary Logo

Institutional members access full text with Ovid®

Clinical Course Score (CCS): A New Clinical Score to Evaluate Efficacy of Neurotrauma Treatment in Traumatic Brain Injury and Subarachnoid Hemorrhage

Brandner, Sebastian MD; Kellermann, Isabel; Hore, Nirjhar MD; Bozhkov, Yavor MD; Buchfelder, Michael MD, PhD

Journal of Neurosurgical Anesthesiology: January 2015 - Volume 27 - Issue 1 - p 26–30
doi: 10.1097/ANA.0000000000000083
Clinical Investigations

Background: Neurotrauma continues to represent a challenging public health issue requiring continual improvement in therapeutic approaches. As no such current system exists, we present in this study the Clinical Course Score (CCS) as a new clinical score to evaluate the efficacy of neurotrauma treatment.

Methods: The CCS was calculated in neurotrauma patients to be the difference between the grade of the Glasgow Outcome Scale 6 months after discharge from our department and the grade of a 1 to 5 point reduced Glasgow Coma Scale on admission. We assessed the CCS in a total of 248 patients (196 traumatic brain injury [TBI] patients and 52 subarachnoid hemorrhage [SAH] patients) who were treated in our Department of Neurosurgery between January 2011 and December 2012.

Results: We found negative CCS grades both in mild TBI and in mild SAH patients. In patients with severe TBI or SAH, we found positive CCS grades. In SAH patients, we found higher CCS scores in younger patients compared with elderly subjects in both mild and severe cases.

Conclusions: The CCS can be useful in evaluating different therapeutic approaches during neurotrauma therapy. This new score might improve assessment of beneficial effects of therapeutic procedures.

Department of Neurosurgery, University Hospital, Erlangen, Germany

The authors have no funding or conflicts of interest to disclose.

Reprints: Sebastian Brandner, MD, Department of Neurosurgery, University Hospital, Schwabachanlage 6, 91054 Erlangen, Germany (e-mail:

Received February 2, 2014

Accepted April 29, 2014

© 2015 by Lippincott Williams & Wilkins