Shazia F Khan, Rashid Nazir.
Indications for Computed Tomography in patients with minor head injury.
Pak J Radiol Jan ;12(4):2-9.

Patients presenting with mild head injury are one of the commonest presentations in the accident and emergency department. Prompt detection of significant intracranial pathology and avoidance of unnecessary hospitalization and cost saving in the relevant patient is the most important consideration in this group of patients. CT scan is widely used in mild head injury patients, although results are often normal. We performed a prospective study to evaluate that should a routine CT scan be performed in all mild head trauma patients (GCS 13-15) or certain clinical guidelines be used for the decision of CT scanning. 45 patients presenting with mild head injury (defined as patients with GCS 13- 15) were included in the study. We found that mild head injury patients (MHI) who had one of the following clinical findings i. e. GCS 13 -14, age above 60 years, history of loss of consciousness, vomiting; headache, deficit in short term memory, seizures, sedation, ENT bleed and skull fracture had more chances of having significant intracranial pathology In our study this was 42.2%. Hence we concluded that all such patients should have a CT Scan done on presentation. 4 patients with GCS 15 with one or more of the clinical findings also had significant intracranial pathologies which Suggest that C.T. Scan should be done in patients with GCS 15 with one or more of the clinical findings. Only one patient with GCS 15/15 without any clinical finding had a skull fracture and pneumocephalus on C.T. Scan but needed no intervention. It is therefore suggested that these patients can be safely send home without C.T. Scan perhaps with a warning sheet. Our results correlated with the available international data.

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