The Utility of Head Ct Scans After Minimal Head Injury

Nagy, KK; Joseph, KT; Krosner,; Roberts, Richard M.; C, Leslie; Dufty, Kirk; Smith, R. W.; Barrett, John; Fildes, JJ

doi:10.1097/00005373-199802000-00068

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“…Some authors believe that a thorough clinical examination of the patient may obviate the need for what they feel is an inefficient use of CT scan in head injury. [ 17 ] Others support the view that clinical examination in head-injured patients may not reliably predict the eventual CT scan findings. [ 4 8 ] Interestingly, increasing concern is being expressed about the hazards of CT and the need for moderation in its use even in head injuries.…”

Section: Discussionmentioning

confidence: 99%

Cranial computed tomography scan findings in head trauma patients in Enugu, Nigeria

Ohaegbulam¹,

Mezue²,

Ndubuisi³

et al. 2011

Surg Neurol Int

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Background:The choice of radiological investigations in head trauma in Africa is influenced by factors such as cost. Some patients who require computed tomography (CT) scan elsewhere are either managed blindly or do not present for it at the appropriate time. This paper evaluates the CT scan findings as they are obtained in cases of head trauma in a region of Nigeria.Methods:Prospectively recorded data of all head injury patients who presented for CT scan between January 2009 and April 2010 at Memfys Hospital for Neurosurgery (MHN), Enugu, Nigeria, were analyzed. Mobile CereTom 8-Slice CT was used in all cases. New and follow-up cases were included.Results:There were 204 CT scans for head trauma (171 new, 33 follow-up), accounting for about 34% of all head CT scans performed with this unit. The male to female ratio was 3.5:1. About 33.9% of the patients were in the third and fourth decades of life. In 19.9% cases, CT was unremarkable, while 80.1% cases had abnormal CT findings. The CT diagnosis was not in keeping with the indication of head trauma in 7%, and 13% had more than one finding. The most common CT findings were: subdural hematoma 30%, cerebral contusions and edema 30.7%, skull fractures 23.4% and extradural hematoma 8.0%. About 64% of the CT findings required surgical interventions. The overall mortality was 11.1%, but amongst the 137 patients who had abnormal CT findings, it was 13.9%.Conclusion:The high yield and diversity of CT scan findings in head trauma patients support the indication for the appropriate use of CT in diagnosis and management of head trauma even in developing countries.

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Section: Discussionmentioning

confidence: 99%