Mild Head Injury: Criteria for Computed Tomography Scan

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%).1 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 cost saving measure to patients and hospitals likewise reduce collective
radiation dose to the population.
Methodology: A retrospective study 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 undergone 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% (n=50), seizures
4% (n=50) 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 patients 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.