Complicated Mild Traumatic Brain Injury and the Need for Imaging Surveillance

World Neurosurgery
Martina StipplerRoger B Davis

Abstract

To evaluate the need for repeat head computed tomography (CT) in patients with complicated mild traumatic brain injury (TBI) determined nonoperative after the first head CT. A total of 380 patients with mild TBI and a positive head CT not needing surgery were included. Changes between first and second head CT were categorized as decreased, increased, or stable. Three patients required neurosurgical intervention (0.8%) after the second CT. There were no significant differences in demographics including age, gender, alcohol consumption, anticoagulation status, time between first and second CT, Glasgow Coma Scale score at admission and discharge, and incidence of subarachnoid hemorrhage, epidural hematoma, contusion, or skull fractures between the operated and nonoperated groups. All patients in the operated group had subdural hematoma compared with 40.8% in the nonoperated group (P = 0.07). All operated patients showed symptoms of neurologic worsening after initial head CT, compared with 2.7% in the nonoperated group (P < 0.001). Moreover, patients who showed neurologic worsening were more likely to show increased intracranial bleeding on repeat head CT, whereas patients who did not show neurologic worsening were more likely to s...Continue Reading

Citations

Oct 13, 2020·The American Journal of Emergency Medicine·Jennifer M SingletonCarlo L Rosen
Oct 20, 2020·The American Journal of Emergency Medicine·Katherine RhameNatalie Kreitzer
Jul 25, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Shou-Chi ChienChih-Yuan Fu
May 8, 2021·Journal of Neurosurgery. Pediatrics·Nir ShimonyGeorge I Jallo

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brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.