INDICATIONS FOR BRAIN CT SCAN IN PATIENTS WITH MINOR HEAD INJURY

Abstract

Objectives The aim of this study is to determine the frequency of utilization, yield for brain injury, incidence of missed injury, and variation in the use of computed tomography (CT) for ED patients with minor head injury. Setting The emergency and radiology department of General Hospital Lahore. Methods It was an observational study. A series of 400 consecutive patients who had been attended at two with minor head injury were prospectively enrolled in this study. In all cases clinical signs and symptoms were collected and a cranial computerized tomography (CT) scan was obtained. The relationship between the occurrence of clinical findings and appearance of intracranial posttraumatic lesions on cranial CT was analyzed by chi-square tests and statistic logistic regression methods, with 95% confidence intervals. Results 400 patients, 51(12.8%) presented brain injuries on CT scan. All patients with abnormal CT scans had at least one of the following factors (risk factors): posttraumatic amnesia, loss of consciousness, posttraumatic seizure, headache, vomiting, focal neurological deficit, skull fracture, coagulopathy or antecedent of treatment with anticoagulants and patient age older than 60 years. No abnormal CT scans were found among patients without any of those risk factors on admission. Vomiting, skull fracture and age greater than 60 years were risk factors significantly correlated to an abnormal cranial CT after head injury. The presence of several risk factors in a patient increased the probability of posttraumatic lesion on CT scan. Conclusions Our study conducted which contain clinical risk factors that can be used as a guide to predict the probability of abnormal CT following minor head injury.