British journal of neurosurgery
-
It is believed by many neurosurgeons that in addition to age and neurological status, the CT patterns of traumatic intracerebral haemorrhages are related to outcome. The aim of this study was to find out whether this is the case. The study was conducted in a regional level I trauma centre in Hong Kong. ⋯ There was an association between temporal haematomas and inpatient mortality, subdural haematomas and inpatient mortality, and bilateral haematomas and unfavourable one-year outcome. In patients with severe head injury, a traumatic haematoma of more than 50 ml was associated higher inpatient mortality. In addition to age and GCS score, the CT patterns of bilateral haematomas, temporal haematomas and associated subdural haematomas were suggestive of poor outcome or mortality.
-
This study was performed to determine the usefulness of repeated brain computed tomography (CT) within 24 hours of blunt head trauma in patients with traumatic intracranial haemorrhages (ICH) and who were initially treated nonsurgically. Factors associated with the worsening of lesions on repeat CT were evaluated. Medical records of all blunt head trauma patients with traumatic ICH admitted to our hospital from January 2003 to December 2006 were retrospectively reviewed. ⋯ After repeat CT, 28 (47%) of the patients in Group 2 underwent neurosurgical interventions. Of the 28 surgically treated patients from Group 2, 6 (10%) exhibited neurological worsening and 22 (37%) appeared neurologically stable. According to our data, we suggest that routine repeat CT within 24 hours after blunt head trauma might minimize potential neurological deterioration in patients with either a GCS lower than 12 or with an epidural haematoma or multiple lesions as indicated on initial CT.
-
National guidelines exist for the investigation and early management of head injury. Alcohol-related head injury is relatively common in clinical practice, and intoxicated patients can be difficult to fit into guidelines for imaging. ⋯ We demonstrate that in normal clinical practice in a major trauma centre, a GCS15 patient with alcohol-related head injury selected to undergo imaging by the Emergency Department team, is more likely to have an abnormality on CT than a sober patient (p = 0.014). Despite the potential for guidelines to lead to many further (and possibly inappropriate) CT investigations to be performed in the intoxicated patient group, this is not demonstrated to be the case in our centre.