Value of repeat cranial computed axial tomography scanning in patients with minimal head injury.
BACKGROUND
Patients with minimal head injury (MHI) and a cranial computed axial tomography (CAT) scan positive for the presence of intracranial injury routinely undergo a repeat CAT scan within 24 hours after injury. The value of this repeat cranial CAT scan is unclear in those patients who are neurologically normal or improving.


METHODS
A retrospective analysis of all adult patients admitted to a level-1 trauma center with MHI and a positive cranial CAT scan during a 32-month period was performed. The need for neurosurgical intervention after repeat CAT scan in patients with a persistently normal or improved neurological examination was recorded.


RESULTS
One hundred fifty-one patients had a persistently normal or improved neurological examination, but none of these patients required neurosurgical intervention after the repeat cranial CAT scan.


CONCLUSIONS
A persistently normal or improving neurological examination in a patient with MHI appears to exclude the need for neurosurgical intervention and thus a repeat cranial CAT scan.
Division of Trauma, Department of Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, University Hospital M-243, 150 Bergen St., Newark, NJ 07103, USA.
Ziad C
ZC
Sifri
David H
DH
Livingston
Robert F
RF
Lavery
Adena T
AT
Homnick
Anne C
AC
Mosenthal
Alicia M
AM
Mohr
Carl J
CJ
Hauser
D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging* / Q000601:surgery; D003422:Critical Care / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019635:Neurosurgical Procedures / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014193:Trauma Centers; D014218:Triage / Q000379:methods*