Adil Aziz, Faisal Mirza, Syed Ali Raza, Sadia Aziz, Hasan Aman, Atif Kazmi, Khaleeq Uz Zaman.
Association of vomiting with intracranial lesion in mild head injury patients.
Pak J Surg Jan ;28(1):25-9.

Objective: “To determine the association of the frequency of intracranial pathology detected in mild head injury patients with post traumatic vomiting.” Study design: It was a cross sectional discriptive study. Place and duration: Patients received at the emergency department or OPD or referred to Pakistan institute of Medical Sciences, Islamabad were included in the study. Pakistan institute of Medical Sciences is a tertiary care hospital that recruits patients from Punjab and Northern areas. Th e data was collected over a period of six months from 1st August 2008 till 31st January 2009. Methodology: Data were analyzed relating to a consecutive series of 206 patients who presented to the emergency department of Pakistan Institute of Medical Sciences, Islamabad. Data was collected through non-probability convenience sampling. Characteristics studied, were CT scan brain fi ndings and the presence and severity of post-traumatic vomiting. Result: Our study included 206 patients with mild head injury. 127 (61.7%) patients presented with vomiting aft er head injury and 79 (38.3%) patients did not vomit. 49 (23.8%) vomited once and 78 (37.9%) vomited on multiple occasions. Vomiting was signifi cantly more common among patients who were found to have an abnormal CT scan. 66.7% with abnormal CT scan vomited, as opposed to 51.5% of those with a normal CT scan. Conversely, among patients with post traumatic vomiting, 72.4% had abnormal CT scan as opposed to 58.2% abnormal CT scans, among patients without vomiting. Th e relation of vomiting with intracranial lesion on CT scan was statistically signifi cant; p=0.035; OR=1.886, 95% CI= 1.042-3.411. Conclusion: Patients with post traumatic vomiting have signifi cantly higher frequency of an intracranial lesion on CT scan. Th ese results support the incorporation of the enquiry, about vomiting, into the guidelines, for mild head injury management.

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