Value of repeat cranial computed axial tomography scanning in patients with minimal head injury

Sifri, Ziad C; Livingston, David H; Lavery, Robert F; Homnick, Adena T; Mosenthal, Anne C; Mohr, Alicia M; Hauser, Carl J

doi:10.1016/j.amjsurg.2003.12.015

« Previous Next »The American Journal of Surgery
Volume 187, Issue 3 , Pages 338-342, March 2004

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

Ziad C Sifri, M.D.
- Division 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
David H Livingston, M.D.
- Division 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
- Corresponding author. Tel.: +1-973-972-6869; fax: +1-973-972-7441.
Robert F Lavery, M.A.
- Division 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
Adena T Homnick, M.P.A.S.
- Division 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
Anne C Mosenthal, M.D.
- Division 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
Alicia M Mohr, M.D.
- Division 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
Carl J Hauser, M.D.
- Division 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

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.

Keywords: Cranial computed axial tomography scan, Neurological status, Neurosurgical intervention, Traumatic brain injury