Indications for brain computed tomography scan after minor head injury

Area of Science:

• Emergency Medicine
• Radiology
• Neuroscience

Background:

• Minor head injury (MHI) is a frequent reason for Emergency Department (ED) visits.
• Brain computed tomography (CT) scans are crucial for diagnosing intracranial lesions after MHI.
• There is ongoing debate regarding the precise indications for brain CT in MHI patients.

Purpose of the Study:

• To identify post-traumatic symptoms, signs, and historical factors that serve as reliable indicators for brain CT scans in MHI patients.
• To determine which clinical indicators are associated with the presence of traumatic intracranial lesions on brain CT scans.

Main Methods:

• A study involving 642 patients over 2 years old with MHI and a Glasgow Coma Scale (GCS) score of ≥13 who underwent brain CT scans.
• Data collection included age, headache, vomiting, loss of consciousness (LOC) or amnesia, post-traumatic seizure, physical evidence of trauma, alcohol intoxication, and anticoagulant use.
• Statistical analysis, including Chi-square tests and logistic regression, was employed to identify significant predictors of abnormal CT findings.

Main Results:

• Out of 642 MHI patients, 388 (60.4%) had no identified risk indicators, and 20 (3.1%) showed abnormal brain CT scans.
• Logistic regression revealed that headache (P=0.006), LOC or amnesia (P=0.024), and alcohol intoxication (P=0.036) were significantly associated with abnormal brain CT findings.
• Vomiting and alcohol intoxication were also identified as risk indicators for abnormal CT scans.

Conclusions:

• Abnormal brain CT scans related to trauma after MHI can be predicted by the presence of specific risk indicators.
• Key predictors include headache, vomiting, loss of consciousness or amnesia, and alcohol intoxication.
• Patients presenting with these indicators following MHI should be considered high-risk and warrant further investigation with brain CT scans.