A prospective study to identify high-yield criteria associated with acute intracranial computed tomography findings in head-injured patients.
We conducted a multicenter, prospective study of head-injured patients to identify high-yield clinical criteria for acute intracranial injuries. Emergency patients with a history of blunt head trauma occurring within 2 weeks and who underwent nonenhanced cranial computed tomography (CT) were entered onto the study during a 12-month period. Of the 264 patients, 32 (12%) had abnormal CT findings. Nine high-yield variables were associated with abnormal CT findings: alcohol use before injury, antegrade amnesia, prolonged loss of consciousness, anisocoria and/or fixed and dilated pupils, abnormal Babinski reflex, focal motor paralysis, cranial nerve deficit, Glasgow coma scale score of less than 15, and clinical signs of basilar skull fracture. Patients 2 years old or younger or older than 60 years of age showed a significantly greater prevalence of abnormal CT findings than patients of other ages.
Schynoll
W
W
Department of Emergency Medicine, Beloit Memorial Hospital, WI 53511.
Overton
D
D
Krome
R
R
Wesolowski
D
D
Wang
A M
AM
Wilson
A
A
Coffey
M
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D001927:Brain Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D001930:Brain Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications*; D004636:Emergency Service, Hospital; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed