Mild head injury: revisited

@article{Thiruppathy2004MildHI,
  title={Mild head injury: revisited},
  author={Subbiah Thiruppathy and Natarajan Muthukumar},
  journal={Acta Neurochirurgica},
  year={2004},
  volume={146},
  pages={1075-1083}
}
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… 

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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.

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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.

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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).

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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

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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.
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