Predictors of Positive CT Scans in the Trauma Patient with Minor Head InjuryThe American Surgeon
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AbstractRoutine 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 headinjuries 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 scanswere 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.
Citation InformationS. G. Moran, Mary C. McCarthy, D. E. Uddin and R. J. Poelstra. "Predictors of Positive CT Scans in the Trauma Patient with Minor Head Injury" The American Surgeon Vol. 60 Iss. 7 (1994) p. 533 - 535 ISSN: 0003-1348
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