title: Indications for brain computed tomography scan after minor head injury.
abstract: OBJECTIVE
  Minor head injury (MHI) is a common injury seen in Emergency Departments (ED). Computed tomography (CT) scan of the brain is a good method of investigation to diagnose intracranial lesions, but there is a disagreement about indications in MHI patients. We surveyed the post-traumatic symptoms, signs or past historical matters that can be used for the indication of brain CT scan.
  
  
  METHODS
  All patients with MHI who were older than 2 years, had a Glasgow Coma Scale (GCS) score ≥13 and were referred to the ED, underwent brain CT scan. Data on age, headache, vomiting, loss of consciousness (LOC) or amnesia, post-traumatic seizure, physical evidence of trauma above the clavicles, alcohol intoxication, and anticoagulant usage were collected. The main outcome measure was the presence of lesions related to the trauma in brain CT scan. For categorical variables, Chi-square test was used.
  
  
  RESULTS
  Six hundred and forty-two patients were examined by brain CT scan after MHI, and 388 patients (60.4%) did not have any risk indicator. Twenty patients (3.1%) had abnormal brain CT scans. The logistic regression model showed that headache (P=0.006), LOC or amnesia (P=0.024) and alcohol (P=0.036) were associated with abnormal brain CT.
  
  
  CONCLUSIONS
  WE SUGGESTED THAT ABNORMAL BRAIN CT SCAN RELATED TO THE TRAUMA AFTER MHI CAN BE PREDICTED BY THE PRESENCE OF ONE OR MORE OF THE FOLLOWING RISK INDICATORS: Headache, vomiting, LOC or amnesia, and alcohol intoxication. Thus, if any patient has these indicators following MHI, he must be considered as a high-risk MHI.
authors.affiliation: Department of Neurosurgery, Sina Trauma and Surgery Research Center, Tehran, Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sharif-Alhoseini
authors.forename: Hossein
authors.initials: H
authors.lastname: Khodadadi
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Chardoli
authors.forename: Vafa
authors.initials: V
authors.lastname: Rahimi-Movaghar
references.citation: JAMA. 2005 Sep 28;294(12):1551-3
references.pmid: 16189370
references.citation: Neurol Med Chir (Tokyo). 2007 Jul;47(7):291-7; discussion 297-8
references.pmid: 17652914
references.citation: J Trauma. 2006 Sep;61(3):558-66
references.pmid: 16966987
references.citation: J Rehabil Med. 2004 Feb;(43 Suppl):28-60
references.pmid: 15083870
references.citation: Clin Neurol Neurosurg. 2007 Jun;109(5):399-405
references.pmid: 17350162
references.citation: J Trauma. 1992 Sep;33(3):385-94
references.pmid: 1404507
references.citation: Ann Emerg Med. 1996 Mar;27(3):290-4
references.pmid: 8599485
references.citation: J Emerg Med. 2003 Feb;24(2):157-62
references.pmid: 12609645
references.citation: J Emerg Med. 1997 Jul-Aug;15(4):453-7
references.pmid: 9279694
references.citation: JAMA. 2005 Sep 28;294(12):1519-25
references.pmid: 16189365
references.citation: Neurosurgery. 1992 Feb;30(2):160-5
references.pmid: 1545882
references.citation: Acta Neurochir (Wien). 1998;140(1):56-64
references.pmid: 9522909
references.citation: J Clin Neurosci. 2004 Nov;11(8):835-9
references.pmid: 15519858
references.citation: Radiology. 2007 Dec;245(3):831-8
references.pmid: 17911536
references.citation: N Engl J Med. 2000 Nov 23;343(21):1570-1
references.pmid: 11184746
references.citation: Br J Neurosurg. 1996 Oct;10(5):453-60
references.pmid: 8922703
references.citation: No Shinkei Geka. 2004 May;32(5):465-70
references.pmid: 15287484
references.citation: Acta Neurochir (Wien). 2000;142(11):1281-5
references.pmid: 11201644
references.citation: Radiology. 2010 Feb;254(2):532-40
references.pmid: 20093524
references.citation: Lancet. 2001 May 5;357(9266):1391-6
references.pmid: 11356436
references.citation: Ann Emerg Med. 1993 Jul;22(7):1148-55
references.pmid: 8517566
references.citation: N Engl J Med. 2000 Jul 13;343(2):100-5
references.pmid: 10891517
references.citation: Ann Emerg Med. 1993 Jul;22(7):1193-6
references.pmid: 8517573
references.citation: Neuroimaging Clin N Am. 2003 May;13(2):273-82
references.pmid: 14506776
references.citation: Brain Inj. 1993 Sep-Oct;7(5):425-30
references.pmid: 8401484
references.citation: Ann Intern Med. 2007 Mar 20;146(6):397-405
references.pmid: 17371884
references.citation: J Neurosurg. 2009 Oct;111(4):688-94
references.pmid: 19284234