The value of cranial computed tomography in high-risk, mildly head-injured patients

The purpose of this article was to assess if high-risk, mildly head-injured patients with normal CT scan present an outcome similar to the group with “low-risk MHI.” A total of 379 hospital charts of inpatients with Glasgow Coma Scale scores of 13, 14, and 15 were reviewed. Information regarding age...

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Bibliographic Details
Published in:Surgical neurology 2006-01, Vol.65, p.S10-S13
Main Authors: de Andrade, Almir Ferreira, de Almeida, Antonio Nogueira, Bor-Seng-Shu, Edson, Lourenço, Leonardo, Mandel, Maurício, Marino, Raul
Format: Article
Language:English
Subjects:
Adult
Craniocerebral Trauma - diagnostic imaging
Craniocerebral Trauma - surgery
CT scan
Female
Follow-Up Studies
Glasgow Coma Scale
Glasgow Outcome Scale
Humans
Male
Mild head injury
Predictive Value of Tests
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Traumatic brain injury
Treatment Outcome
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Summary:The purpose of this article was to assess if high-risk, mildly head-injured patients with normal CT scan present an outcome similar to the group with “low-risk MHI.” A total of 379 hospital charts of inpatients with Glasgow Coma Scale scores of 13, 14, and 15 were reviewed. Information regarding age, fGCS, trauma mechanism, cranial CT scan findings, hospital course, and follow-up using the GOS were obtained from all patients. Patients were separated in 3 groups: fGCS 13 (46 patients), fGCS 14 (138 patients), and fGCS 15 (195 patients). The groups with different scores on fGCS did not differ regarding CT scan abnormalities, surgical treatment, or outcome. Patients were also separated in 2 groups based on CT scan findings: 266 patients had CT interpreted as abnormal and 113 had CT interpreted as normal. The 2 groups differed statistically regarding surgical treatment and scores on GOS ( P < .05). There was no statistically significant difference between the 2 groups regarding sex, trauma mechanism, fGCS, or age. Our findings support the idea that a normal cranial CT scan in patients with fGCS scores of 13 or higher ascertain a low-risk MHI outcome and, therefore, such patients must be included in this category of traumatic brain injury. On the other hand, patients with cranial CT scan abnormalities should be included in the group with moderate head injury.
ISSN:0090-3019
1879-3339
DOI:10.1016/j.surneu.2005.11.034