Role of sequel CT scan head after twenty four hours of traumatic head injury

Authors

  • Pradeep Kumar Balmiki Assistant Professor Surgery, Department of General Surgery, People’s College of Medical Sciences And Research Centre, Bhopal, M.P.
  • Anjeev K. Chourasia Assistant Professor Surgery, Department of General Surgery, Gandhi Medical College, Bhopal, M.P.
  • Ishwar Dayal Chourasia Assistant Professor Surgery, Department of General Surgery, Gandhi Medical College, Bhopal, M.P.

Keywords:

CT scan, Contusions, Glasgow coma score (GCS), Traumatic head injury

Abstract

Background:The CT scan has become popular in cases of head injury. Since its inception it has become single best reliable tool for head injury diagnosis.

Methods:In this study 65 cases (M: 48; 68.0% and F: 17; 29.23%) with traumatic head injury admitted and initially managed conservatively at Hamidia hospital, Bhopal starting from Nov 2008 to Oct 2009.  

Results: The most common cause of injury was road traffic accidents (40 cases 61.5%). Altered sensorium was the most common symptom in 55 cases (84.61.0%), followed by vomiting in 49 cases (75.38%). Contusions were the most common radiological findings in 80.0% (52 cases) followed by extradural haematoma in 18.46% and pneumocephalus in 16.92%. Out of these the most common location for contusion was frontal (14 cases), followed by parietal (12 cases) and then bilateral contusions in 10 cases. Repeat scan showed increase in volume of contusion in 29 cases (44.61%), no change in 26 cases (40.0%) and decrease in 10 cases. The increase was mainly due to edema in 18 cases (27.69%) and due to actual increase in contusion in only 11 cases. Only 4 cases needed operative intervention.

Conclusions:It is concluded that repeat CT scan in mild to moderate head injury should be done when: there is clinical deterioration, age >65 years, multiple traumatic lesions on first CT scan head, first CT scan done early.

 

Metrics

Metrics Loading ...

References

Roka YB, Kumar P, Bista P, Sharma GR, Adhikari D, Khadka NK, et al. Role of repeat CT scan in initially inoperable cases of traumatic head injury. Nepal Med Coll J. 2008;10:225-9.

French BN, Dublin AB. The value of CT scanning in the management of 1000 consecutive cases of head injuries. Surg Neurol. 1977;7:171-83.

Roberson FC, Kishore PR, Miller JD, Lipper MH, Becker DP. The value of serial computerized tomography in the management of severe head injury. Surg Neurol. 1979 Aug;12(2):161-7.

Velmahos G, Gervarini A, Petrovick L, Dorer DJ, Doran ME, Spaniolas K, et al. Routine repeat head CT for minimal head injury in unconscious. J Trauma. 2006;60:494-501.

Dharap SB, Akhandekar A, Pandey A, Sharma AK. Repeat CT scan in closed head injury. Injury. 2005;36(3):412-6.

Servadei F, Nanni A, Nasi MT, Zappi D, Vergoni G, Giuliani G, et al. Evolving brain lesions in the first 12 hours after head injury: analysis of 37 comatose patients. Neurosurgery. 1995;5:899-907.

Kobayashi S, Nakazawa S, Otsuka T. Clinical value of serial computed tomography with severe head injury. Surg Neurol. 1983;30:25-9.

Frankhauser H, Kener M. Delayed development of extradural haematoma. Acta Neurochir. 1982;60:29-35.

Bucci MN, Phillips TW, McGillicuddy JE. Delayed epidural hemorrhage in hypotensive multiple trauma patients. Neurosurgery. 1986 Jul;19(1):65-8.

Gentleman D, Nath F, Macphersan P. Diagnosis and management of delayed traumatic intracerebral haematomas. Br J Neurosurg. 1982;3(3):367-72.

Patel NY, Hoyt DB, Nakaji P, Marshall L, Holbrook T, Coimbra R, et al. Traumatic brain injury: patterns of failure of nonoperative management. J Trauma. 2000;48:367-74.

Sifri ZC, Homnick AT, Vaynman A, Lavery R, Liao W, Mohr A, et al. A prospective evaluation of the value of repeat cranial computed tomography in patients with minimal head injury and an intracranial bleed. J Trauma. 2006;61:862-7.

Brown CV, Weng J, Oh D, Salim A, Kasotakis G, Demetriades D, et al. Does routine serial computed tomography of the head influence management of traumatic brain injury? A prospective evaluation. J Trauma. 2004;57:939-43.

Downloads

Published

2016-12-13

How to Cite

Balmiki, P. K., Chourasia, A. K., & Chourasia, I. D. (2016). Role of sequel CT scan head after twenty four hours of traumatic head injury. International Surgery Journal, 2(2), 195–199. Retrieved from https://www.ijsurgery.com/index.php/isj/article/view/535

Issue

Section

Original Research Articles