Availability of computed tomography for the management of head injuries in England and Wales.

Senior neuroradiologists or radiologists of 42 hospitals with computed tomography available for NHS patients in England and Wales were contacted by postal questionnaire about the use of this facility in the management of patients with acute head injuries. Replies were obtained from 39 hospitals. Requests for computed tomography from general surgeons or physicians and staff of accident and emergency departments received positive responses for scanning with only half to three-quarters the frequency of responses to requests from neurosurgeons. Continuous computed tomography facilities were available generally to neurosurgeons. The combined effect of partial responses to requests and the availability of the computed tomography service meant that only 44% of hospitals gave a continuous service for general surgeons or physicians. The percentage of hospitals giving a continuous service to accident and emergency departments was 54%. It appeared that computed tomography scanning was being used most often as a diagnostic/management instrument after clinical selection among patients with head injuries rather than as an instrument to be used in primary assessment.