Abstract |
Routine cerebral CT scanning of patients with minor head injuries has been advocated as a screening procedure for hospital admission. The purpose of this study was to determine whether there were characteristics of the trauma patient with a minor head injury. Glasgow Coma Scale (GCS) of 13-15, that would predict a positive cerebral CT scan. An analysis of 200 patients with potential head injuries transported to our regional trauma center was performed. The following characteristics were analyzed as possible predictors: scene GCS (SC-GCS), emergency room GCS (ER-GCS), a change in GCS from scene to emergency room, loss of consciousness (LOC), and focal neurological deficit. Forty-eight per cent (96/200) of the patients underwent CT scanning of the head. CT scans were positive in 4 per cent (8/200) of the total group and 8.3 per cent (8/96) of those who underwent CT scanning. In the patients without LOC and ER-GCS of 13-15, all CT scans were negative (95% confidence interval 0.0% to 3.4%). In the 93 patients with LOC, eight patients had a positive scan (P < 0.001). Of the nine patients who sustained a skull fracture, five had a positive CT (55.6%; 95% confidence interval 21.2% to 86.3%) (P < 0.0001). Of all the patients with positive CT scans, two underwent emergent craniotomy: one for a depressed skull fracture with underlying contusion, the other for a temporal bone fracture and an epidural hematoma. Both patients had LOC and SC-GCS and ER-GCS of 15.(ABSTRACT TRUNCATED AT 250 WORDS)
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Authors | S G Moran, M C McCarthy, D E Uddin, R J Poelstra |
Journal | The American surgeon
(Am Surg)
Vol. 60
Issue 7
Pg. 533-5; discussion 535-6
(Jul 1994)
ISSN: 0003-1348 [Print] United States |
PMID | 8010569
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Brain Injuries
(diagnostic imaging, surgery)
- Child
- Craniocerebral Trauma
(diagnostic imaging, surgery)
- Emergency Service, Hospital
- Female
- Glasgow Coma Scale
- Humans
- Male
- Middle Aged
- Patient Admission
- Predictive Value of Tests
- Retrospective Studies
- Skull Fractures
(diagnostic imaging, surgery)
- Tomography, X-Ray Computed
- Triage
(methods)
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