Publication:

Role of sequel CT scan head after twenty four hours of traumatic head injury

Background The CT scan has become popular in cases of head injury. Since its inception it has become single best reliable tool for head injury diagnosis.

Methods In this study 65 cases (M: 48; 68.0% and F: 17; 29.23%) with traumatic head injury admitted and initially managed conservatively at Hamidia hospital, Bhopal starting from Nov 2008 to Oct 2009.

Results The most common cause of injury was road traffic accidents (40 cases 61.5%). Altered sensorium was the most common symptom in 55 cases (84.61.0%), followed by vomiting in 49 cases (75.38%). Contusions were the most common radiological findings in 80.0% (52 cases) followed by extradural haematoma in 18.46% and pneumocephalus in 16.92%. Out of these the most common location for contusion was frontal (14 cases), followed by parietal (12 cases) and then bilateral contusions in 10 cases. Repeat scan showed increase in volume of contusion in 29 cases (44.61%), no change in 26 cases (40.0%) and decrease in 10 cases. The increase was mainly due to edema in 18 cases (27.69%) and due to actual increase in contusion in only 11 cases. Only 4 cases needed operative intervention.

Conclusions It is concluded that repeat CT scan in mild to moderate head injury should be done when: there is clinical deterioration, age >65 years, multiple traumatic lesions on first CT scan head, first CT scan done early.