Management of acute head injuries in a Norwegian county--effects of introducing CT scanning in a local hospital.

Introducing a new diagnostic tool, a CT scanner, in a county hospital resulted in a marked redistribution of the handling of acute/severe head injuries. Before the introduction of the CT scanner, a substantial number of these patients were referred to the regional neurosurgical unit. After having acquired its own scanner, the county hospital took over most of the diagnostic and therapeutic tasks concerning acute head injuries, surgery inclusive. This change in policy resulted in more patients surviving without sequelae, and reduced the average latency to surgery. The proportion of operated patients increased considerably, from 23% to 64%. In a relatively large proportion of the patients, there were complications with continuous ICP monitoring using the subdural bolt. This procedure was therefore discontinued. In spite of the improved results caused by the observed redistribution, the study indicates a need for additional training of the county hospital staff.