Skull radiography in the evaluation of acute head trauma: a survey of current practice.

A survey was conducted to determine the extent to which skull radiography continues to be used for the evaluation of head trauma. Of 53 hospitals with emergency departments and computed tomography (CT) available full time, only 6% (n = 3) reported that skull radiographs were never a part of the evaluation of acute head injuries. At more than half of the institutions, skull radiographs were obtained always or often in cases of head trauma. High usage rates occurred at teaching and nonteaching institutions and were not related to the availability of CT or the size of the hospitals. CT was always employed in cases of severe head trauma, and skull radiography was frequently used in cases of minor injuries. Magnetic resonance imaging was rarely, if ever, used for evaluating head trauma. Skull radiography continues to be employed at a high rate for the evaluation of head trauma long after it has been demonstrated to provide little or no useful information in such cases.