Value of repeat cranial computed axial tomography scanning in patients with minimal head injury
Presented at the 32nd Annual Meeting of the Western Trauma Association, Whistler–Blackcombe, British Colombia, Canada, February 24 to March 1, 2002
Received 27 May 2003; received in revised form 21 August 2003
Abstract
Background
Patients with minimal head injury (MHI) and a cranial computed axial tomography (CAT) scan positive for the presence of intracranial injury routinely undergo a repeat CAT scan within 24 hours after injury. The value of this repeat cranial CAT scan is unclear in those patients who are neurologically normal or improving.
Methods
A retrospective analysis of all adult patients admitted to a level-1 trauma center with MHI and a positive cranial CAT scan during a 32-month period was performed. The need for neurosurgical intervention after repeat CAT scan in patients with a persistently normal or improved neurological examination was recorded.
Results
One hundred fifty-one patients had a persistently normal or improved neurological examination, but none of these patients required neurosurgical intervention after the repeat cranial CAT scan.
Conclusions
A persistently normal or improving neurological examination in a patient with MHI appears to exclude the need for neurosurgical intervention and thus a repeat cranial CAT scan.
aDivision of Trauma, Department of Surgery, University of Medicine and Dentistry of New Jersey–New Jersey Medical School, University Hospital M-243, 150 Bergen St., Newark, NJ 07103, USA
ABSTRACT