title: Serial Brain CT Scans in Severe Head Injury without Intracranial Pressure Monitoring.
abstract: OBJECTIVE
  The intracranial pathologies after head trauma should be usually progressed. It is clearly visualized in the non-invasive brain CT. The invasive monitor such as intracranial pressure (ICP) monitoring may be accompanied with the complications. This study aims whether the patients with severe head injury could be managed with serial CT scans.
  
  
  METHODS
  The medical records of 113 patients with severe head injury in the prospectively enrolled trauma bank were retrospectively analyzed. After the emergency care, all the patients were admitted to the intensive care unit for the aggressive medical managements. Repeat brain CT scans were routinely taken at 6 hours and 48 hours after the trauma. ICP monitoring was restrictively applied for the uncertain intracranial pressure based on the CT. The surgical intervention and the mortality rate were analyzed.
  
  
  RESULTS
  Immediate surgical intervention after the initial CT scan was done in 47 patients. Among the initially non-surgical patients, 59 patients were managed with the serial CT scans and 7 with the ICP monitoring. Surgical interventions underwent eventually for 10 patients in the initially non-surgical patients; 1 in the ICP monitoring and 9 in the serial CT. The mortality rate was 23.7% in the serial brain CT and 28.6% in the ICP monitoring. There was no statistical difference between two groups in the aspect of mortality (p=0.33).
  
  
  CONCLUSIONS
  Serial CT scans in time could be a good way to monitor the intracranial progression in the severe head injury and reduce the implantation of an invasive ICP probe.
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Dong-Seong
authors.initials: DS
authors.lastname: Shin
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Sun-Chul
authors.identifier: 0000-0001-8008-0749
authors.initials: SC
authors.lastname: Hwang
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Bum-Tae
authors.initials: BT
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Je Hoon
authors.identifier: 0000-0002-4656-0113
authors.initials: JH
authors.lastname: Jeong
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Soo-Bin
authors.initials: SB
authors.lastname: Im
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Won-Han
authors.initials: WH
authors.lastname: Shin
keywords: CT; Intracranial pressure monitoring; Mortality; Severe head injury