The clinical profile and outcome of conservatively managed traumatic brain injuries and its implications on the timing of repeat CT scans
Keywords:Computed tomography, Neurological deterioration, Traumatic brain injury
Background: Outcome of traumatic brain injury is multi factorial. It is common to follow up the conservatively managed patients with repeated CT scans at specific intervals. The study was to observe the epidemiology of TBI and ascertain utility of repeating CT scans in conservatively managed TBI.
Methods: 318 patients with TBI admitted to a tertiary care center for a period of 1 year was studied. Adult patients, who have undergone multiple CT scans were included and patients underwent surgery or expired after first CT scan excluded. Personal details, clinical details and reason for repeated CT scan was studied. The change in management based on serial CT scans was measured as outcome.
Results: Road traffic accidents were the cause of 69.1% of TBI. 72% of the patients were male. Commonest CT finding was occurrence of mixed lesions, seen in 44.3% patients. In patients who underwent repeated CT scans, the mean number of repeat CT scans were 3.7 CT (SD=1.001), while that of elective cases were 2.40 scans (SD=0.629). The use of routine CT scan for follow up did not alter the management of patients with TBI when compared to patients who underwent elective scans as none of them underwent any surgical intervention.
Conclusions: RTA are commonest cause for TBI. Use of routine CT scans was not of advantage over elective scans as none of the patients had any change in management with use of repeat CT scans.
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