Are CT scans for head injury patients always necessary?

The study reported here sought to identify a group of adult head injury patients in whom computerized axial tomographic (CT) scans were not necessary. The study was limited to patients 18 years of age and older with a history of minor head injury who remained neurologically stable for 20 minutes after arrival at the trauma center, maintained a Glasgow Coma Scale score of at least 13, and had no clinical evidence of basal skull fracture. These patients had a uniformly good neurologic prognosis. The CT scan did not have any prognostic or therapeutic implications. Of a total of 348 patients studied, 12 had an abnormal CT scan with no neurologic deficits or sequelae, and all of them had an uneventful hospital discharge without readmission. It appears that a routine CT scan for minimal head injury patients is an inefficient use of personnel and equipment which may add to the ever increasing financial burden on trauma centers.