Indications for brain CT scan in patients with minor head injury

Abstract

BACKGROUND: Minor head injury is the most common type of head injury. Despite its high prevalence and a lot of studies, there is much controversies about the management of these patients. We performed this study to find indications for brain CT scan according to clinical signs and symptoms. METHODS: We did this prospective cohort study in two university hospitals (Alzahra and Kashani) for one year enrolling 682 consecutive patients with minor head injury (GCS = 15) and recording all clinical signs and symptoms to find which could be used as predictors for brain injuries. X2 and logistic regression with 95% confidence interval were used for analysis. RESULTS: Of 682 patients, 46 (6.7%) had brain injuries in CT scan. All patients with abnormal CT scans had at least one of the following risk factors: post traumatic amnesia, post traumatic unconsciousness, post traumatic seizure, headache, confusion, vomiting, focal neurological deficit, skull fracture, coagulopathy or history of taking anticoagulants and age more then 60 years. We didn't find any abnormality in brain CT scan of patients who did not have any of these factors on admission. Confusion, Vomiting, skull fracture and age > 60 years had significant correlation with brain injuries. We also found those patients who had more than one risk factor had more abnormalities in CT scan. CONCLUSION: Not all patients with minor head injury need brain CT scan. Clinical factors can be used as indications for brain CT scan in these patients. KEY WORDS: minor head injury, brain CT scan.