title: The value of protocol-driven CT scanning in stab wounds to the head.
abstract: A prospective study involving 179 patients with cranial and orbital stab wounds was undertaken to evaluate the incidence and relationship of clinical findings, radiographs, and computed tomography (CT) findings and treatment decision. Indications for a CT scanning of the head are a of loss of consciousness, convulsions, any neurological deficit, palpable or visible fracture on the skull X-ray film after an attack with a sharp instrument, presence of an impaling weapon. A CT scan and plain radiography were performed in 179 patients. There were pathological CT findings in 128 patients (71.51%). In contrast only 35/179 (19.5%) X-ray films were positive; 11 (6.15%) patients had a palpable fracture. Approximately 80% of all cranial injuries would remain undetected if the diagnosis would be based on a visible fracture. Fifty percent of patients had an admission GCS of 15/15. The importance of a CT scan and the limited benefit of plain radiography alone in stab injuries to the head is discussed.
authors.affiliation: Trauma Unit, Groote Schuur Hospital, University of Cape Town, South Africa. exaris@hotmail.com
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
authors.forename: Andreas
authors.initials: A
authors.lastname: Stettbacher
authors.forename: Peter C
authors.initials: PC
authors.lastname: Bautz
authors.forename: Jane
authors.initials: J
authors.lastname: Terries
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D005260:Female; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000293:injuries; D011446:Prospective Studies; D012886:Skull / Q000293:injuries; D013557:Switzerland / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014951:Wounds, Stab / Q000000981:diagnostic imaging* / Q000453:epidemiology