#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Mild Brain Injury – Intracranial Complications and Indication Criteria for CT Imaging


Authors: R. Kaiser;  L. Mencl;  P. Haninec
Authors‘ workplace: Neurochirurgická klinika 3. LF UK a FN Královské Vinohrady, Praha
Published in: Cesk Slov Neurol N 2011; 74/107(3): 330-334
Category: Short Communication

Overview

Intracranial bleeding is revealed by CT scan in about 10% of patients who are examined after mild traumatic brain injury. The objective of this study is to analyze retrospectively the incidence of intracranial haemorrhage in patients admitted to our department with a diagnosis of concussion. A total of 274 patients were admitted to our department with such a diagnosis during the year 2009. CT examinations were requested in 188 cases. The indication criteria were age over 60 years, skull fracture, coagulopathy or dangerous mechanism of injury (e.g. traffic accident). Intracranial bleeding had occurred in 41 patients (21.8%) examined by CT scan even if their clinical status appeared good. Two of them had to be operated upon in the light of deterioration in their neurological findings. The purpose of this study is to warn against the danger intrinsic to these injuries, because even if the patient’s clinical status appears good, they may have intracranial bleeding, which may, in turn – if rarely – require operation.

Key words:
mild traumatic brain injury – brain concussion – intracranial complications – computed tomography – risk factors


Sources

1. Vos PE, Battistin L, Birbamer G, Gerstenbrand F, Potapov A, Prevec T et al. EFNS guideline on mild traumatic brain injury: report of an EFNS task force. Eur J Neurol 2002; 9(3): 207–219.

2. Kozler P, Netuka D, Ostrý S. Lehká mozková poranění a jejich akutní management: zkušenosti z neurochirurgického pracoviště. Cesk Slov Neurol N 2004; 67/100(3): 162–168.

3. Bednařík J, Ambler Z, Ehler E. Lehká mozková poranění a jejich akutní management: přehled současného stavu a návrh doporučení. Cesk Slov Neurol N 2003; 66/99(2): 131–134.

4. Anderson T, Heitger M, Macleod AD. Concussion and mild head injury. Pract Neurol 2006; 6: 342–357.

5. Tagliaferri F, Compagnone C, Korsic M, Servadei F, Kraus J. A systematic review of brain injury epidemiology in Europe. Acta Neurochir (Wien) 2006; 148(3): 255–268.

6. Jagoda AS, Bazarian JJ, Bruns JJ jr, Cantrill SV, Gean AD, Howard PK et al. Clinical policy: neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting. Ann Emerg Med 2008; 52(6): 714–748.

7. Levine Z. Mild traumatic brain injury: part 1: Determining the need to scan. Can Fam Physician 2010; 56(7): 346–349.

8. Bednařík J. Editorial. Cesk Slov Neurol N 2004; 67/100(3): 148.

9. Ibañez J, Afrikan F, Pedraza S et al. Reliability of clinical guidelines in the detection of patiens at risk following mild head injury: results of a prospective study. J Neurosurg 2004; 100(5): 825–834.

10. Stiell IG, Wells GA, Vendemheen K, Clement C, Lesiuk H, Laupacis A et al. The Canadian CT Head Rule for patients with minor head injury. Lancet 2001; 357(9266): 1391–1396.

11. Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM. Indications for computed tomography in patients with minor head injury. N Engl J Med 2000; 343(2): 100–105.

12. Smits M, Dippel DW, de Haan GG, Dekker HM, Vos PE, Kool DR et al. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA 2005; 294(12): 1519–1525.

13. Stiell IG, Clement CM, Rowe BH, Schull MJ, Brison R, Cass D et al. Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. JAMA 2005; 294(12): 1511–1518.

14. Saboori M, Ahmadi J, Farajzadegan Z. Indications for brain CT scan in patients with minor head injury. Clin Neurol Neurosurg 2007; 109(5): 399–405.

15. Nagy KK, Joseph KT, Krosner SM, Roberts RR, Leslie CL, Dufty K et al. The utility of head computed tomography after minimal head injury. J Trauma Injury Infect Crit Care 1999; 46(2): 268–273.

16. Dunham CM, Diates S, Cooper C. Compelling evidence for discretionary brain computed tomographic imaging in those patients with mild cognitive impairment after blunt trauma. J Trauma Injury Infect Crit Care 1996; 41(4): 679–686.

17. af Geijerstam JL, Britton M. Mild head injury. Reliability of early head computed tomographic findings in triase for admission. Emerg Med J 2005; 22(2): 103–107.

18. af Geijerstam JL, Oredsson S, Britton M. Medical outcome after immediate computed tomography or admission for observation in patients with mild head injury: randomised controlled trial. BMJ 2006; 333(7566): 465–471.

19. Livingston DH, Lavery RF, Passannante MR et al. Emergency department discharge of patiens with negative cranial computed tomography scan after minimal head injury. Ann Surg 2000; 232(1): 126–132.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 3

2011 Issue 3

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#