Role of Computed Tomography in Minor Head Injury

Abstract

Minor Head Injuries (mHI), by their vast numbers, burden the already scarce hospital services by consuming man power and other resources which can be utilized for more deserving HI cases if a scanning protocol can be devised for managing these mHI. One hundred consecutive patients with Glasgow Coma Score of 15 (mHI) underwent a thorough neurological examination, x-rays of skull, cervical spine (AP and lateral views), and chest followed by computerized tomographic (CT) scan of brain. Results were analyzed and intervention was made in abnormal findings. Average age was 26.8 years. Seventy three percent of these patients were males, and 23% of them were children (<12 years). Road side accidents (76%), fall from height (18%) and assaults (6%) were the common causes. Three of the five skull fractures seen were depressed fractures. 23% x-ray films were of poor quality. Risk factors (nausea, vomiting, ear, nose or throat bleeding, headache and giddiness) were present in 54 patients. One or more of these risk factors was present in 16 of 20 patients with abnormal CT scans. Intracranial bleed was seen in 11 cases. Extradural hematoma was seen in five, subdural Patients with normal CT head were released after 24 hours of hospitalization. hematoma, intracerebral bleed and traumatic subarachnoid hemorrhage in two cases each. CT in patients with risk factors not only fetches abnormal CT scans, but also reduces incidence of unnecessary scan by 46%. Early CT in minor HI patients without risk factor and normal neurological examination and mental status with normal findings facilitates early discharge from hospital.

Keywords

Computed Tomography (CT) - head injury - minor head injury

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