[Scanography in head injuries. Critical study of 500 cases]

In 22 months, about 2 000 patients were hospitalized for head injury and 410 of these had computerized tomography to determine the presence and extent of intracranial pathology. 165 patients had normal C.T. scan, and in 245 cases the scan showed an intracranial pathology: 132 brain contusions, 45 epidural hematomas, 36 subdural hygromas, 32 chronic subdural hematomas, 8 intracerebral hematomas, 2 pneumocephalus. The C.T. scan is a very useful technique for evaluation of the head injured patient in emergency. For epidural hematomas, mortality rate which was 16% before C.T. scan period decreased to 8% after C.T. scan period. The C.T. scan has a definite advantage over angiography in brain contusions. Instead of seeing only mass effect, one can tell on C.T. scans whether the abnormality is a small hematoma, an area of contused swollen brain, an hemorrhagic contusion, or a brain oedema. The surgical decisions are more precise with this information. In the management of head injury, we think that C.T. scan must be repeat because many patients developed new lesions and delayed hematomas: intracerebral, subdural, epidural.