TY - JOUR
T1 - Utility of routine serial computed tomography for blunt intracranial injury
AU - Chao, Alexander
AU - Pearl, Jonathan
AU - Perdue, Philip
AU - Wang, Dennis
AU - Bridgeman, Amy
AU - Kennedy, Susan
AU - Ling, Geoff
AU - Rhee, Peter
PY - 2001/11
Y1 - 2001/11
N2 - To determine the utility of routine serial head computed tomography (H-CT) for predicting need for invasive neurosurgical intervention in patients with blunt intracranial injuries (BICI). Patients treated at a Level I trauma center with BICI over a 4-year period were reviewed. Of the 4,273 blunt trauma patients evaluated, 9.7% (415/4,273) were diagnosed as having BICI. Invasive intervention (craniotomy, ICP monitoring, ventriculostomy, or angiogram) was performed in 41.2% (171/415) of patients with BICI. Of these, 94.7% (162/171) had the procedure performed as a result of the initial H-CT. The remaining 5.3% (9/171) had the intervention performed as a result of a subsequent H-CT. Serial H-CT documented worsening of BICI in 32.3% (64/198) of the patients, but only those who had significant corresponding clinical deterioration had an invasive procedure as a result. In patients with an unchanged or normal neurologic exam, a routine serial H-CT did not influence subsequent invasive neurosurgical intervention.
AB - To determine the utility of routine serial head computed tomography (H-CT) for predicting need for invasive neurosurgical intervention in patients with blunt intracranial injuries (BICI). Patients treated at a Level I trauma center with BICI over a 4-year period were reviewed. Of the 4,273 blunt trauma patients evaluated, 9.7% (415/4,273) were diagnosed as having BICI. Invasive intervention (craniotomy, ICP monitoring, ventriculostomy, or angiogram) was performed in 41.2% (171/415) of patients with BICI. Of these, 94.7% (162/171) had the procedure performed as a result of the initial H-CT. The remaining 5.3% (9/171) had the intervention performed as a result of a subsequent H-CT. Serial H-CT documented worsening of BICI in 32.3% (64/198) of the patients, but only those who had significant corresponding clinical deterioration had an invasive procedure as a result. In patients with an unchanged or normal neurologic exam, a routine serial H-CT did not influence subsequent invasive neurosurgical intervention.
KW - Blunt trauma
KW - Head computed tomography (H-CT)
KW - Intensive care unit
KW - Intracranial injury
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U2 - 10.1097/00005373-200111000-00008
DO - 10.1097/00005373-200111000-00008
M3 - Article
C2 - 11706333
AN - SCOPUS:0035206255
VL - 51
SP - 870
EP - 876
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 5
ER -