The value of cranial computed tomography in high-risk, mildly head-injured patients.
BACKGROUND
The purpose of this article was to assess if high-risk, mildly head-injured patients with normal CT scan present an outcome similar to the group with "low-risk MHI."


METHODS
A total of 379 hospital charts of inpatients with Glasgow Coma Scale scores of 13, 14, and 15 were reviewed. Information regarding age, fGCS, trauma mechanism, cranial CT scan findings, hospital course, and follow-up using the GOS were obtained from all patients.


RESULTS
Patients were separated in 3 groups: fGCS 13 (46 patients), fGCS 14 (138 patients), and fGCS 15 (195 patients). The groups with different scores on fGCS did not differ regarding CT scan abnormalities, surgical treatment, or outcome. Patients were also separated in 2 groups based on CT scan findings: 266 patients had CT interpreted as abnormal and 113 had CT interpreted as normal. The 2 groups differed statistically regarding surgical treatment and scores on GOS (P < .05). There was no statistically significant difference between the 2 groups regarding sex, trauma mechanism, fGCS, or age.


CONCLUSIONS
Our findings support the idea that a normal cranial CT scan in patients with fGCS scores of 13 or higher ascertain a low-risk MHI outcome and, therefore, such patients must be included in this category of traumatic brain injury. On the other hand, patients with cranial CT scan abnormalities should be included in the group with moderate head injury.
de Andrade
Almir Ferreira
AF
Department of Neurology of Hospital das Clínicas of São Paulo University, Medical School, Rue Eneas Carvalho de Aguiar 255, Caixa Postal 8091, São Paulo (SP), Brazil. alandrade@hcnet.usp.br
de Almeida
Antonio Nogueira
AN
Bor-Seng-Shu
Edson
E
Lourenço
Leonardo
L
Mandel
Maurício
M
Marino
Raul
R
D000328:Adult; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome