[Indications for computed tomography in patients with mild head injuries]

Area of Science:

• Neurotraumatology
• Emergency Medicine
• Radiology

Background:

• Mild head injuries are common, but identifying patients with intracranial lesions requires careful clinical assessment.
• Glasgow Coma Scale (GCS) scores of 15 indicate mild head injury, yet intracranial lesions can still occur.

Purpose of the Study:

• To identify clinical parameters associated with intracranial lesions in patients with mild head injuries (GCS 15).
• To determine the incidence of intracranial lesions in specific mild head injury patient subgroups.

Main Methods:

• Evaluation of 371 head trauma patients with GCS 15 admitted to the emergency room.
• Exclusion of patients with focal neurological deficits, penetrating trauma, or multiple traumas.
• Comparison of cranial CT findings with clinical parameters and cranial X-ray sensitivity/specificity.

Main Results:

• Intracranial lesions were more frequent in patients over 60 and after motorway accidents.
• Loss of consciousness and post-traumatic seizures correlated with higher pathological sequelae.
• Cranial X-ray showed 38.2% sensitivity and 93.2% specificity compared to CT.

Conclusions:

• The incidence of intracranial lesions in mild head injury patients (GCS 15) without specific risk factors is low (0.6%).
• Age over 60 and specific injury mechanisms are associated with increased risk.
• Clinical parameters like headache, nausea, and vomiting were not significant predictors.