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Predictors of positive CT scans in the elderly trauma patients with minor head injury. Case reports and review of the literature
Annals of General Psychiatry volume 7, Article number: S302 (2008)
Background
The purpose of this study was to determine whether there were characteristics of the trauma patient with a minor head injury. Glasgow Coma Scale (GCS) of 13-15, that would predict a positive cerebral CT scan.
Materials and methods
An analysis of 300 patients with potential head injuries transported to our department was performed. The following characteristics were analyzed as possible predictors: 1. scene GCS, 2. emergency room GCS, 3. a change in GCS from scene to emergency room, 4. loss of consciousness, 5. focal neurological deficit.
Results
50 per cent (150/300) of the patients underwent CT scanning of the head. CT scans were positive in 5,3 per cent (16/300) of the total group and 10.6 per cent (16/150) of those who underwent CT scanning. In the patients without LOC and ER-GCS of 13-15, all CT scans were negative.
Conclusions
Of all the patients with positive CT scans, 4 underwent emergent craniotomy: 2 for a depressed skull fracture with underlying contusion, and 2 for a temporal bone fracture and an epidural hematoma. Both patients had LOC and SC-GCS and ER-GCS of 15. We present our cases and finally we performed a review of the literature.
References
Livingston DH, Loder PA, Hunt CD: Minimal head injury: is admission necessary?. Am Surg. 1991, 57 (1): 14-7.
Borczuk P: Predictors of intracranial injury in patients with mild head trauma. Ann Emerg Med. 1995, 25 (6): 731-6. 10.1016/S0196-0644(95)70199-0.
Dacey RG, Alves WM, Rimel RW, Winn HR, Jane JA: Neurosurgical complications after apparently minor head injury. Assessment of risk in a series of 610 patients. J Neurosurg. 1986, 65 (2): 203-10.
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Syrmos, N., Gramatikopoulos, I., Valadakis, V. et al. Predictors of positive CT scans in the elderly trauma patients with minor head injury. Case reports and review of the literature. Ann Gen Psychiatry 7 (Suppl 1), S302 (2008). https://0-doi-org.brum.beds.ac.uk/10.1186/1744-859X-7-S1-S302
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DOI: https://0-doi-org.brum.beds.ac.uk/10.1186/1744-859X-7-S1-S302