Mild head injury: revisited

  title={Mild head injury: revisited},
  author={Subbiah Thiruppathy and Natarajan Muthukumar},
  journal={Acta Neurochirurgica},
SummaryObjective. 1. To define the incidence of positive CT scans in patients with different grades of mild head injury (MHI), 2. To identify clinical predictors of positive CT scans, 3. To evaluate the usefulness of plain radiographs in the triage of patients with MHI, 4. To evaluate frequency and nature of surgical intervention in MHI, 5. To evaluate the risk of deterioration in MHI, and 6. To find out whether patients with normal neurological examination and normal CT can be safely… 

Impact of clinical symptoms on CT ordering policy in minor head injuries.

The authors conclude that minor or mild head injuries should prompt a CT as recommended by Canadian or New Orleans guidelines and that the strongest scientific evidence available at this time would suggest that a CT strategy is a safe way to triage patients for admission.

Role of cranial computed tomography in predicting clinical outcome in patients with minor head injury.

CT should be used as a primary screening investigation in all patients with minor head injury as patients with normal neurological examination and normal CT scan can be safely discharged without need for inpatient or patient observation, thereby making the hospital resources available for more serious patients.

Utility of CT in Head Injury- A Prospective Study

This study showed a significant association of overall CT positivity with patients sociodemographic and clinical factors such as male gender, elderly age group (>60 years), history of alcohol consumption, LOC >5 min, history of vomiting, History of seizures, evidence of ear bleed,Evidence of nosebleed, and GCS 12 (moderate and Severe head injury).

Computed Tomography Profile and its Utilization in Head Injury Patients in Emergency Department: A Prospective Observational Study

The study showed significant association of CT positivity with five variables: LOC >5 min, vomiting, seizures, ear bleed, and nosebleed, and recommend following: CT is indicated in all patients with moderate and severe head injury (GCS ≤12).

Delayed neurological deterioration after mild head injury: cause, temporal course, and outcomes.

The incidence of delayed neurological deterioration after MHI with ICH is low and usually occurs within 24 hours after admission, but it results in significant morbidity and mortality if it is the result of progressive intracranial hemorrhage.

Management of Traumatic Brain Injury

The authors focus on the importance of plain skull X-rays and CT scan in the work-up of mild TBI patients and on the indications for decompressive craniectomy for the relief of intractable elevation of intracranial pressure following severe TBI.

CT head findings in suspected cases of head injury

CT was found highly sensitive in demonstrating fractures and was considered the modality of choice when imaging suspected cases of head injury and in emergency patients due to its accuracy, reliability, safety and wide availability.

Clinically-Important Brain Injury and CT Findings in Pediatric Mild Traumatic Brain Injuries: A Prospective Study in a Chinese Reference Hospital

This study highlights the important roles that parents and school administrators in the development of preventive measures to reduce the risk of traumatic brain injury in children and identifies children who had a head trauma at very low risk of clinically important TBI for whom CT might be unnecessary.

Neurosurgical intervention in patients with mild traumatic brain injury and its effect on neurological outcomes.

Data in this study demonstrate that patients with mTBI requiring NSI have higher mortality rates and worse neurological outcomes and should therefore be classified separately frommTBI patients not requiringNSI.

Diagnostic Utility of Conventional Radiography in Head Injury.

Whenever there is facility of CT scan is available, the patient of head injury should not underwent X-ray as it can only delay the diagnosis of an associated intracranial injury and exposes the already traumatised patient to harmful radiations.



Limitations of neurological assessment in mild head injury.

It is recommended that any patient who has suffered a loss of consciousness or amnesia following head injury have an urgent cranial CT scan, and it is unlikely that further refinements in the clinical evaluation will result in diagnostic accuracy comparable with that of CT scanning.

The use of CT scanning to triage patients requiring admission following minimal head injury.

Recent data have suggested that patients with both a normal cranial CT scan and normal neurologic examination following minimal head injury (MHI) have no risk of neurologic deterioration. This study

The clinical utility of computed tomographic scanning and neurologic examination in the management of patients with minor head injuries.

It is believed that CT scanning is essential in the management of patients with MHI and that if the neurologic examination is normal and the scan is negative patients can be safely discharged from the emergency room.

Predictors of positive CT scans in the trauma patient with minor head injury.

Routine cerebral CT scanning of patients with minor head injuries has been advocated as a screening procedure for hospital admission and characteristics of the trauma patient with a minor head injury, including Glasgow Coma Scale of 13-15, were analyzed as possible predictors.

The value of computed tomographic scans in patients with low-risk head injuries.

It is suggested that history and physical examination alone are not adequate to assess head injury or severity of risk and that the addition of a CT scan greatly improves patient assessment, and head injuries in patients with a Glasgow Coma Scale score of 13 should be classified as "moderate" rather than "mild" in severity and risk.

Mild head injury: a plea for routine early CT scanning.

It is concluded that clinical observation with or without skull x-ray films is inadequate to rule out potentially dangerous intracranial lesions in apparently mild head injuries.

The utility of head computed tomography after minimal head injury.

CT is a useful test in patients with minimal head injury because it may lead to a change in therapy in a small but significant number of patients, and subsequent hospital observation adds nothing to the CT results and is not necessary in patientswith isolated minimalHead injury.

Inadequacy of bedside clinical indicators in identifying significant intracranial injury in trauma patients.

Emergency department CT scans should be performed on all patients referred to the trauma service with previously classified mild- or low-risk criteria for intracranial trauma, regardless of GCS score, because current bedside methods are inadequate.