The canadian CT head rule study for patients with minor head injury: Rationale, objectives, and methodology for phase I (derivation)

Stiell, Ian G.; Lesiuk, Howard; Wells, George A.; McKnight, R. Douglas; Brison, Robert J.; Clement, Catherine M.; Eisenhauer, Mary A.; Greenberg, Gary H.; MacPhail, Iain; Reardon, Mark; Worthington, James; Verbeek, Richard; Rowe, Brian H.; Cass, Daniel T.; Dreyer, Jonathan; Holroyd, Brian R.; Morrison, Laurie J.; Schull, Michael J.; Laupacis, Andreas

doi:10.1067/mem.2001.116796

Cited by 105 publications

(52 citation statements)

References 91 publications

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“…Although numerous criteria have been developed to guide neuroimaging decisions after head trauma, none are sensitive and specific enough to diagnose all intracranial pathology. [65][66][67][68][69] at high risk of a structural brain injury identified on CT scan after a head injury. 70 Approximately 22% of the head injuries in this study were sport-related.…”

Section: Neuroimagingmentioning

confidence: 99%

Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

586

445

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Sport-related concussion is a "hot topic" in the media and in medicine. It is a common injury that is likely underreported by pediatric and adolescent athletes. Football has the highest incidence of concussion, but girls have higher concussion rates than boys do in similar sports. A clear understanding of the definition, signs, and symptoms of concussion is necessary to recognize it and rule out more severe intracranial injury. Concussion can cause symptoms that interfere with school, social and family relationships, and participation in sports. Recognition and education are paramount, because although proper equipment, sport technique, and adherence to rules of the sport may decrease the incidence or severity of concussions, nothing has been shown to prevent them. Appropriate management is essential for reducing the risk of long-term symptoms and complications. Cognitive and physical rest is the mainstay of management after diagnosis, and neuropsychological testing is a helpful tool in the management of concussion. Return to sport should be accomplished by using a progressive exercise program while evaluating for any return of signs or symptoms. This report serves as a basis for understanding the diagnosis and management of concussion in children and adolescent athletes.

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Section: Neuroimagingmentioning

confidence: 99%

Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

586

445

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“…There have been many studies performed with clear guidelines about when to image patients who present with head trauma. 8,13,[15][16][17][18][19] Other studies have assessed early follow-up imaging for inpatients, which were performed within 12 to 48 hours of the original injury with varying conclusions. 1,2,4-6,9,13,20,21 The indications for follow-up imaging of TBI patients when they are seen in the office after discharge remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Results of delayed follow-up imaging in traumatic brain injury

Befeler

Gordon

Khan

et al. 2016

JNS

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OBJECT There is a paucity of scientific evidence available about the benefits of outpatient follow-up imaging for traumatic brain injury patients. In this study, 1 year of consecutive patients at a Level 1 trauma center were analyzed to determine if there is any benefit to routinely obtaining CT of the head at the outpatient follow-up visit. METHODS This single-institution retrospective review was performed on all patients with a traumatic brain injury seen at a Level 1 trauma center in 2013. Demographic data, types of injuries, surgical interventions, radiographic imaging in inpatient and outpatient settings, and outcomes were assessed through a review of the institution’s trauma registry, patient charts, and imaging. RESULTS Five hundred twenty-five patients were seen for traumatic brain injury in 2013 at Regional One Health in Memphis, Tennessee. One hundred eighty-five patients (35%) presented for outpatient follow-up, all with CT scans of the head. Seven of these patients (4%) showed worsening of their intracranial injuries on outpatient imaging studies; however, surgical intervention was recommended for only 3 of these patients (2%). All patients requiring an intervention had neurological deterioration prior to their follow-up appointment. CONCLUSIONS These experiences suggest that outpatient follow-up imaging for traumatic brain injury should be done selectively, as it was not helpful for patients who did not exhibit worsening of neurological signs or symptoms. Furthermore, routine outpatient imaging results in unnecessary resource utilization and radiation exposure.

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“…Patienten mit stumpfen Verletzungen des Schädels werden zunächst als "leichtes SHT" kategorisiert, wenn im Rahmen der neurologischen Beurteilung 13-15 Punkte für die Glasgow Coma Scale (GCS) ermittelt werden. Allerdings zeigen bis zu 15% dieser Patienten in der kraniellen Computertomographie (CCT) eine zerebrale Lä-sion, etwa 1% müssen einer neurochirurgischen Intervention oder Operation zugeführt werden, 5-15% geben 1 Jahr nach dem Unfall noch Beschwerden an [2,3,6,7,9].…”

Section: Einführung Zum Themaunclassified

Das „leichte“Schädel-Hirn-Trauma

Kanz¹,

Kreimeier

2011

Notfall Rettungsmed

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The canadian CT head rule study for patients with minor head injury: Rationale, objectives, and methodology for phase I (derivation)

Cited by 105 publications

References 91 publications

Sport-Related Concussion in Children and Adolescents

Sport-Related Concussion in Children and Adolescents

Results of delayed follow-up imaging in traumatic brain injury

Das „leichte“Schädel-Hirn-Trauma

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