title: The traumatic brain injury: diagnosis and management at emergency department by general surgeon. A retrospective critical analysis on the use of the CT head scan.
abstract: OBJECTIVE
  In recent decades, considerable progress has been made in diagnosis and     management of cranial trauma patients. Computed Tomography has resulted in a     revolution in head injury diagnosis, making it possible to detect cases suitable     for surgical treatment in a rapid, non-invasive manner. We present our     experience in treating patients with head injuries at Emergency Department by     describing the process and the criteria under which any diagnostic test is     performed focusing in CT head scan.
  
  
  METHODS
  Between 2007-2009 we     studied 1356 adult patients (725 male and 631 female) who came at the emergency     department claiming head injury. The factors registered were the mechanism of     injury, the neurological evaluation, the Glasgow Coma Scale (GCS), the specialty     of the doctor who made the first evaluation, and finally in which cases and with     which criteria the CT scan was performed.
  
  
  RESULTS
  Only a disproportionate small     number of the patients who arrive at the emergency room claiming head injury     require neurosurgical intervention (4.8% in our study). The majority of the CT     scans who are performed as emergency procedure have no pathological findings     (53.4%).
  
  
  CONCLUSIONS
  The general surgeon with the appropriate education is able     to evaluate the patients with head injury.
authors.affiliation: University Hospital of Alexandroupolis, First Department of Surgery, Alexandroupoli, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Siasios
authors.forename: Soultana
authors.initials: S
authors.lastname: Foutzitzi
authors.forename: Savas
authors.initials: S
authors.lastname: Deftereos
authors.forename: Michael
authors.initials: M
authors.lastname: Karanikas
authors.forename: Theodosıos
authors.initials: T
authors.lastname: Birbilis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D013502:General Surgery / Q000193:education / Q000592:standards / Q000706:statistics & numerical data; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D014218:Triage / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D055815:Young Adult