MILD HEAD INJURY: CRITERIA FOR COMPUTED TOMOGRAPHY SCAN
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Abstract
Background/Objective: Mild Head Injury (MHI) is the most common type of head trauma, and forms a majority of the injuries seen in the trauma unit (65–85%). This study was aimed at using previously identified clinical risk factors to determine which category of patients with MHI would not need to undergo Computed Tomography (CT). This may serve as a cost-saving measure to patients and hospitals, and likewise reduce collective radiation dose to the population.
Methodology: A retrospective study was conducted at the trauma unit of a teaching hospital situated in the Cape Metropole. CT scan images of 50 patients aged 14 years and above who had MHI and underwent CT examination were retrieved from the archive. Patients’ information, clinical history and resultant CT findings were collated. Clinical risk factors were correlated with abnormal and normal CT scan findings. Data were analyzed using chi-square statistic at 95% confidence interval.
Results: Twenty-three (46%) of the patients had abnormal CT findings, and all presented with one or more of these risk factors: severe headache (10%), skull fracture (20%), scalp injury (6%), loss of consciousness (LOC) (8%) and intoxication (2%). The results were not statistically significant when compared with the normal CT scans group. Four patients (8%) with no risk factors had normal CT scans. All the patients presenting with the clinical risk factors of nausea and vomiting (6%), and seizures (4%) had normal CT scan findings.
Conclusion: Certain clinical risk factors can be used to suggest the probability of abnormal CT scan in patients with MHI. Patients with no risk factors, such as those with confusion and disorientation, are more likely to have normal CT findings and may therefore be exempted from CT examination. Further studies with larger sample size may be helpful in validating these findings.
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