Clinical assessment of head injuries in motorcyclists involved in traffic accidents: A prospective, observational study

Abstract

Objective: to review the clinical assessment of head injuries in motorcyclists involved in traffic accidents. Method: prospective observational study, including adult motorcyclists involved in traffic accidents in a period of 12 months. Patients sustaining signs of intoxication were excluded. A modification of the Canadian Head CT Rules was used to indicate computed tomography (CT). Patients not undergoing CT were followed by phone calls for three months. Collected variables were compared between the group sustaining head injuries and the others. We used chi-square, Fisher, and Student’s t for statistical analysis, considering p<0.05 as significant. Results: we included 208 patients, 99.0% were wearing helmets. Seventeen sustained signs of intoxication and were excluded. Ninety (47.1%) underwent CT and 12 (6.3%) sustained head injuries. Head injuries were significantly associated with Glasgow Coma Scale<15 (52.3% vs. 2.8% - p<0,001) and a positive physical exam (17.1% vs. zero - p<0,05). Four (2.1%) patients with intracranial mass lesions needed surgical interventions. None helmet-wearing patients admitted with GCS=15 and normal physical examination sustained head injuries. Conclusion: Head CT is not necessary for helmet-wearing motorcyclists admitted with GCS=15 and normal physical examination.