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Serial computerized tomographic evaluations in traumatic head injury.

D N Cope1, E S Date, E Y Mar

  • 1National Rehabilitation Hospital, Washington, DC 20010.

Archives of Physical Medicine and Rehabilitation
|July 1, 1988
PubMed
Summary
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Routine computerized tomography (CT) scans during inpatient rehabilitation can detect new neurological lesions in head-injured patients. Early detection via serial CT scans may prevent further brain injury in this population.

Area of Science:

  • Neurosurgery
  • Neurology
  • Radiology

Background:

  • Head-injured patients admitted to rehabilitation units may develop new lesions requiring intervention.
  • Assessing neurological progress in these patients can be challenging.

Purpose of the Study:

  • To evaluate the utility of serial computerized tomography (CT) scans in identifying post-acute neurological lesions in patients undergoing inpatient rehabilitation.
  • To determine if routine CT scanning can aid in the early diagnosis of complications after severe traumatic brain injury.

Main Methods:

  • A prospective study of 47 patients with traumatic head injuries admitted to an inpatient unit.
  • Serial CT scans were performed at admission, one month, and three months post-admission, unless significant clinical improvement occurred.

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Main Results:

  • Nine out of 41 scanned patients (22%) required neurosurgical intervention for newly detected lesions (ventricular enlargement, subdural hematoma, cerebral abscess).
  • Seven of these nine patients (78%) had pathological changes identified exclusively on post-admission CT scans.
  • Only two patients had pre-admission scans showing changes.

Conclusions:

  • Serial CT scanning is valuable for detecting significant neurological lesions in the post-acute phase of traumatic brain injury during rehabilitation.
  • Implementing routine CT scans can facilitate earlier diagnosis and potentially minimize further brain injury in the rehabilitation setting.