Do we routinely need cranial computed tomography for mild head injuries in Turkey?

Abstract

The objectives of this study were to determine the role of clinical parameters in detecting intracranial injury and to find out whether cranial computed tomography (CT) is routinely needed for mild head injury (MHI) in Turkey. This retrospective study was conducted by reviewing the records of patients with MHI who underwent cranial CT in our emergency department. We carried out multiple logistic regression analysis, and odds ratios with 95% confidence intervals were calculated by using SPSS 15.0. This study included 923 patients. Positive cranial CT findings were determined in 17 patients (1.8%) and six of them (0.6%) underwent surgery. Statistically significant correlations were found among headache, presence of clinical findings of skull fracture, focal neurological deficit and positive cranial CT findings. Although the incidence of the intracranial lesions, especially those requiring surgery, is low in MHI, the liberal use of CT scanning in MHI seems to be justified in countries such as Turkey.

Accuracy of Canadian CT head rule in predicting positive findings on CT of the head of patients after mild head injury in a large trauma centre in Saudi Arabia

“…had an opposing result that showed that use of the CCHR had increased the number of CT scans and hospital admissions instead of decreasing them, which was consistent with our results. 3,10–12 Further studies are needed to evaluate the benefits and limitations of the CCHR.…”

“…The CCHR has very high sensitivity of 99–100% and a specificity of 48–77% in predicting the need for neurological intervention. 3 Its diagnostic value and superiority has been validated in some studies, along with the potential to decrease inhospital admission with CCHR guided practice. 4 The CCHR has also been shown to be more specific than the New Orleans criteria in predicting the need for neurosurgical intervention based on the results of CT examinations.…”

Pediatric Minor Head Trauma: Factors Affecting the Anxiety of Parents

“…14 Due to these reasons, whether cranial CT should routinely be used for minor head trauma patients in the ED or not has been a topic of research. 9,13,15-17…”

Role of headache management in minor head injury before performing brain CT scan - can intravenous morphine sulfate predict intracranial injury?

“…The former is more dominant in a context that health policies emphasize on cost-effective use of resources or where resources are scarce and CT is not extensively available, whereas the latter is favored in a context that the fear of litigation is high. [5] Several studies have assessed different indicators predicting abnormal CT scan, [10][11][12][13][14][15][16][17][18] and different criteria and guidelines have been developed for judicious utilization of CT scan aiming to reduce the number of unnecessary scans and at the same time not to jeopardize optimal patient care. [3,4,6,9,[19][20][21] The Canadian CT Head Rule (CCHR) [3] and the New Orleans Criteria (NOC) [6] are among the most widely studied decision rules.…”