Routine repeat head CT for minimal head injury is unnecessary

The Journal of Trauma
George C VelmahosAlasdair K Conn

Abstract

Patients with MHI and a positive head computed tomography (CT) scan frequently have a routine repeat head CT (RRHCT) to identify possible evolution of the head injury requiring intervention. RRHCT is ordered based on the premise that significant injury progression may take place in the absence of clinical deterioration. In a Level I urban trauma center with a policy of RRHCT, we reviewed the records of 692 consecutive trauma patients with Glasgow Coma Scale scores of 13-15 and a head CT (October 2004 through October 2005). The need for medical or surgical neurologic intervention after RRHCT was recorded. Patients with a worse and unchanged RRHCT were compared, and independent predictors of a worse RRHCT were identified by stepwise logistic regression. There were 179 patients with MHI and RRHCT ordered. Of them, 37 (21%) showed signs of injury evolution on RRHCT and 7 (4%) required intervention. All 7 had clinical deterioration preceding RRHCT. In no patient without clinical deterioration did RRHCT prompt a change in management. A Glasgow Coma Scale score less than 15 (13 or 14), age higher than 65 years, multiple traumatic lesions found on first head CT, and interval shorter than 90 minutes from arrival to first head CT predict...Continue Reading

Citations

Apr 11, 2009·The Journal of Trauma·Tiffany K BeeTimothy C Fabian
Jul 7, 2009·Journal of Neurosurgery·Hussein AlahmadiMichael D Cusimano
Dec 27, 2011·Journal of Neurosurgery·Chad W Washington, Robert L Grubb
Mar 26, 2014·The Journal of Trauma and Acute Care Surgery·Bellal JosephPeter Rhee
Nov 15, 2013·Journal of Neurotrauma·Jonathan J LeeWael F Asaad
Aug 12, 2014·Brain Injury : [BI]·Bellal JosephPeter Rhee
Oct 4, 2013·Brain Injury : [BI]·Amir Saied SeddighiAfsoun Seddighi
Apr 17, 2012·Journal of the American College of Surgeons·Farid F MuakkassaKamel Muakkassa
Apr 28, 2010·Journal of the American College of Surgeons·Bradley W ThomasDonald E Barker
Dec 21, 2006·Seminars in Pediatric Neurology·Kevin E Gordon
Apr 19, 2015·Critical Care : the Official Journal of the Critical Care Forum·Hiba Abdel-AzizBarbara M Hileman
Apr 16, 2015·Journal of the American College of Surgeons·Leily NaraghiGeorge C Velmahos
Oct 23, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·E P ThelinC Nordenvall
Jan 19, 2017·The Journal of Trauma and Acute Care Surgery·Paul R LewisSteven R Shackford
Jun 8, 2017·The Journal of Trauma and Acute Care Surgery·Asad AzimBellal Joseph
Nov 22, 2017·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Brian J YunAli S Raja
Sep 12, 2015·Journal of Korean Neurosurgical Society·Won-Hyung KimSang-Dae Kim
Mar 19, 2019·The Journal of Trauma and Acute Care Surgery·Angela M CrawfordDeborah M Stein
Jul 12, 2017·The Journal of Trauma and Acute Care Surgery·Farshad NassiriAvery B Nathens
Jun 20, 2013·The Journal of Trauma and Acute Care Surgery·Bellal JosephPeter Rhee
Apr 27, 2016·The Journal of Trauma and Acute Care Surgery·Ting ZhaoGeorge C Velmahos
May 25, 2013·The Journal of Trauma and Acute Care Surgery·Natasha V NayakZiad C Sifri
Jul 31, 2020·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Ravishankar Pillenahalli MaheshwarappaGirish Bathla
Jun 17, 2020·Trauma Surgery & Acute Care Open·Abid D KhanRichard P Gonzalez
Dec 14, 2016·Acta neurochirurgica·Eric Peter ThelinBo-Michael Bellander
Jun 28, 2019·The Journal of Trauma and Acute Care Surgery·Angela M CrawfordDeborah M Stein
Dec 23, 2017·The British Journal of Radiology·Orly OhanaEyal Klang

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