Reliability of clinical guidelines in the detection of patients at risk following mild head injury: results of a prospective study

Ibañez, Javier; Arikán, Fuat; Pedraza, Salvador; Sánchez, E. González; Poca, María; Rodríguez, David Avelar; Rubio, Enrique

doi:10.3171/jns.2004.100.5.0825

Cited by 142 publications

(138 citation statements)

References 55 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…11) The rate of CT abnormality is 3% to 13% and surgical intervention rate is 0.2% to 0.4% in patients with GCS score 15 and amnesia/LOC, 3,4,7,14,19,20,27,28) and the rate of CT abnormality is 4.9% to 6.3% and surgical intervention rate is 0.08% in patients with GCS score 15 without amnesia/LOC. 2,9,25) The present findings were similar, with rate of CT abnormality of 3.5% and surgical intervention rate of 0.3%.…”

Section: Ct Indications In Mild Head Injurysupporting

confidence: 69%

“…No relationship between bleeding tendency and abnormal CT was found, as bleeding tendency was only examined in 645 of 1,014 patients (64%) in the no CT abnormality group. Coagulopathy has been considered a risk factor for intracranial injury, 9,33) but low-dose aspirin does not increase the risk of intracranial hemorrhage in patients older than 60 years of age. 26) The presence of fracture was only assessed in 59% of our patients, but had a strong influence on intracranial lesions, as previously reported.…”

Section: Ct Indications In Mild Head Injurymentioning

confidence: 99%

“…28) The indication for skull radiography is limited to patients with GCS score 15 and only LOC/amnesia, 34) one other symptom, 5,24,32,34) or symptoms without vomiting, but only if CT is recommended but not available. 25) Many studies have reported increased risk of intracranial lesions in patients with head injury aged over 65 years 9,29) or over 60 years. 2,4,5,7,16,24,34) Aging is one risk factor, but it is unlikely that there is a specific age threshold above which the risk suddenly increases.…”

Section: Ct Indications In Mild Head Injurymentioning

confidence: 99%

See 2 more Smart Citations

Indications for Computed Tomography in Patients With Mild Head Injury

Ono

Wada

Takahara

et al. 2007

Neurol. Med. Chir.(Tokyo)

136

View full text Add to dashboard Cite

The factors affecting outcome were analyzed in 1,064 patients, 621 males and 443 females aged 10 to 104 years (mean 46 ± 23 years), with mild head injury (Glasgow Coma Scale [GCS] score AE14) but no neurological signs presenting within 6 hours after injury. Intracranial lesion was found in 4.7% (50/1,064), and 0.66% (7/1,064) required surgical treatment. The Japan Coma Scale (JCS) and GCS assessments were well correlated (r ＝ 0.797). Multivariate analysis revealed significant correlations between computed tomography (CT) abnormality and age AE60 years, male sex, JCS score AE1, alcohol consumption, headache, nausea/vomiting, and transient loss of consciousness (LOC)/amnesia. Univariate analysis revealed that pedestrian in a motor vehicle accident, falling from height, and mechanisms of injuries except blows were correlated to intracranial injury. No significant correlations were found between craniofacial soft tissue injury and intracranial injury. Patients with occipital impact, nonfrontal impact, or skull fracture were more likely have intracranial lesions. Bleeding tendency was not correlated with CT abnormality. The following indications were proposed for CT: JCS score À0, presence of accessory symptoms (headache, nausea/vomiting, LOC/amnesia), and age AE60 years. These criteria would reduce the frequency of CT by 29% (309/1,064). Applying these indications to subsequent patients with GCS scores 14-15, 114 of 168 patients required CT, and intracranial lesions were found in 13. Two refused CT. Fifty-four of the 168 patients did not need CT according to the indications, but 38 of the 54 patients actually underwent CT because of social reasons (n ＝ 21) or patient request (n ＝ 17). These indications for CT including JCS may be useful in the management of patients with mild head injury.

show abstract

Section: Ct Indications In Mild Head Injurysupporting

confidence: 69%

Section: Ct Indications In Mild Head Injurymentioning

confidence: 99%

Section: Ct Indications In Mild Head Injurymentioning

confidence: 99%

See 1 more Smart Citation

Indications for Computed Tomography in Patients With Mild Head Injury

Ono

Wada

Takahara

et al. 2007

Neurol. Med. Chir.(Tokyo)

136

View full text Add to dashboard Cite

show abstract

“…All head CT scans were initially read by the on-duty neurosurgeon and subsequently reviewed by radiologist. An abnormal CT scan was defined as an acute intracranial lesion therefore excluding isolated skull fracture or chronic subdural effusion [20,21]. Neurosurgical procedure was defined as craniotomy to repair an acute traumatic injury.…”

Section: Methodsmentioning

confidence: 99%

Two Different Approaches in Obtaining Head Computerized Tomography Scan in Minor Head Injuries

Golden

2013

J Neurol Res

View full text Add to dashboard Cite

Background: The management of minor head injury (GCS score of 15) especially in the use of computed tomography (CT) scan is still controversial. As a big and developing country, Indonesia faced some problems in the management of minor head injuries. Those problems were limited number of CT scan, big number of minor head injured patients assessed in emergency unit and far distance between small cities and referral centers. This study was aimed to provide different approaches in obtaining CT scan in this group of patients.

show abstract

“…Tačiau komplikacijos, kurios būdingos ūminei traumai, lengvos galvos smegenų traumos atveju yra santykinai retos -intrakranijinių pažei-dimų rizika apie 10% [15] (sumušimas, subdūrinė ar epidūrinė hematomos, smegenų patinimas, subarachnoidinė hemoragija). 1% nustatytų pakitimų reikalauja neurochirurginio gydymo [15][16][17][18], mirtingumas tarp suaugusiųjų 0,1 % ir dar mažesnis tarp vaikų [19][20].…”

Section: Sveikatos Mokslai / Health Sciences In Eastern Europeunclassified

Dažnai tiems patiems pacientams atliekamų galvos smegenų kompiuterinės tomografijos tyrimų priežastys

2015

View full text Add to dashboard Cite

Raktažodžiai: kompiuterinė tomografija, traukulinis sindromas, galvos smegenų trauma, galvos smegenų kraujotakos sutrikimai, galvos smegenų navikinis procesas. SantraukaStraipsnyje pateikiamos dažniausios galvos smegenų kompiuterinės tomografijos (KT) tyrimų, atliktų Lietuvos sveikatos mokslų universiteto ligoninės Kauno klinikų (LSMUL KK) skubiosios pagalbos skyriuje (SPS) tiems patiems pacientams, priežas-tys; šis tyrimas jiems atliekamas dažniau nei vieną kartą per metus. Apžvelgiama literatūra, susijusi su visų pacientų galvos smegenų KT tyrimo atlikimo dažnio mažinimu ir racionalizavimu. Tyrimo tikslas -nustatyti, ar yra ryšys tarp galvos smegenų KT tyrimų dažnio ir priežasčių (indikacijų) bei stacionarizavimo dažnio. Tyrimui atsitiktine tvarka atrinktas 131 pacientas, iš kurių 123 pacientų (830 galvos smegenų KT) duomenys panaudoti tyrime. Statistinio reikšmingumo lygmuo buvo pasirinktas a = 0,05. Galvos smegenų KT tyrimų vidutiniš-kai atlikta po 6,75 (±3,939) vienam žmogui. 52,8 proc. pacientų buvo atlikta daugiau nei 5 KT tyrimai. Dažniausios priežastys: trauma 56,63 proc. ir galvos smegenų kraujotakos sutrikimai 28,55 proc. Statistiškai reikšmingo ryšio tarp SPS atliekamų tyrimų skaičiaus ir stacionarizavimų skaičiaus nėra. Įvadas ir literatūros apžvalgaKompiuterinė tomografija (KT) labai svarbus diagnostikos įrankis. Dažni KT tyrimai sudaro didelę pacientų medicininių tyrimų metu gaunamos jonizuojančios spinduliuotės dalį. Racionalizuojant tyrimų atlikimo dažnį, indikacijas, būtų galima sumažinti pacientų gaunamą apšvitos jonizuojančiąja spinduliuote dozę. Svarbu išsiaiškinti daž-nai atliekamų KT tyrimų priežastis.

show abstract

Reliability of clinical guidelines in the detection of patients at risk following mild head injury: results of a prospective study

Cited by 142 publications

References 55 publications

Indications for Computed Tomography in Patients With Mild Head Injury

Indications for Computed Tomography in Patients With Mild Head Injury

Two Different Approaches in Obtaining Head Computerized Tomography Scan in Minor Head Injuries

Dažnai tiems patiems pacientams atliekamų galvos smegenų kompiuterinės tomografijos tyrimų priežastys

Contact Info

Product

Resources

About