BACKGROUND: Patients with minimal head injury (MHI) and a cranial computed axial tomography (CAT) scan positive for the presence of intracranial injury routinely undergo a repeat CAT scan within 24 hours after injury. The value of this repeat cranial CAT scan is unclear in those patients who are neurologically normal or improving. METHODS: A retrospective analysis of all adult patients admitted to a level-1 trauma center with MHI and a positive cranial CAT scan during a 32-month period was performed. The need for neurosurgical intervention after repeat CAT scan in patients with a persistently normal or improved neurological examination was recorded. RESULTS: One hundred fifty-one patients had a persistently normal or improved neurological examination, but none of these patients required neurosurgical intervention after the repeat cranial CAT scan. CONCLUSIONS: A persistently normal or improving neurological examination in a patient with MHI appears to exclude the need for neurosurgical intervention and thus a repeat cranial CAT scan.
BACKGROUND:Patients with minimal head injury (MHI) and a cranial computed axial tomography (CAT) scan positive for the presence of intracranial injury routinely undergo a repeat CAT scan within 24 hours after injury. The value of this repeat cranial CAT scan is unclear in those patients who are neurologically normal or improving. METHODS: A retrospective analysis of all adult patients admitted to a level-1 trauma center with MHI and a positive cranial CAT scan during a 32-month period was performed. The need for neurosurgical intervention after repeat CAT scan in patients with a persistently normal or improved neurological examination was recorded. RESULTS: One hundred fifty-one patients had a persistently normal or improved neurological examination, but none of these patients required neurosurgical intervention after the repeat cranial CAT scan. CONCLUSIONS: A persistently normal or improving neurological examination in a patient with MHI appears to exclude the need for neurosurgical intervention and thus a repeat cranial CAT scan.
Authors: Natalie Kreitzer; Kimberly Hart; Christopher J Lindsell; Brittany Betham; Yair Gozal; Norberto O Andaluz; Michael S Lyons; Jordan Bonomo; Opeolu Adeoye Journal: Am J Emerg Med Date: 2017-01-25 Impact factor: 2.469
Authors: Daniel K Nishijima; Jason S Haukoos; Craig D Newgard; Kristan Staudenmayer; Nathan White; David Slattery; Preston C Maxim; Christopher A Gee; Renee Y Hsia; Joy A Melnikow; James F Holmes Journal: Ann Emerg Med Date: 2012-09-27 Impact factor: 5.721
Authors: Daniel K Nishijima; Matthew Sena; Joseph M Galante; Kiarash Shahlaie; Jason London; Joy Melnikow; James F Holmes Journal: Ann Emerg Med Date: 2013-12-04 Impact factor: 5.721
Authors: Natalie Kreitzer; Michael S Lyons; Kim Hart; Cristopher J Lindsell; Sora Chung; Andrew Yick; Jordan Bonomo Journal: Acad Emerg Med Date: 2014-10 Impact factor: 3.451