Navigation Links
No need for routine repeated CT scans after mild head trauma, reports neurosurgery
Date:1/3/2013

Philadelphia, Pa. (January 3, 2013) When initial computed tomography (CT) scans show bleeding within the brain after mild head injury, decisions about repeated CT scans should be based on the patient's neurological condition, according to a report in the January issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The study questions the need for routinely obtaining repeated CT scans in patients with mild head trauma. "The available evidence indicates that it is unnecessary to schedule a repeat CT scan after mild head injury when patients are unchanged or improving neurologically," according to the study by Dr. Saleh Almenawer and colleagues of McMaster University, Hamilton, Ont., Canada.

Are Repeated Scans Necessary after Mild Head Trauma?

In a review of their hospital's trauma database, the researchers identified 445 adult patients with mild head injury who had evidence of intracranial hemorrhage (ICH)bleeding within the brainon an initial CT scan. In many trauma centers, it's standard practice to schedule a second CT scan within 24 hours after ICH is detected, to make sure that the bleeding has not progressed.

To evaluate the need for routine repeated scans, Dr. Almenawer and colleagues looked at how many patients needed surgery or other additional treatments, and whether the change in treatment was triggered by changes in the patients' neurological condition or based on the routine CT scan alone. (For patients whose neurological condition worsened, CT was performed immediately.)

Overall, 5.6 percent of the patients required a change in treatment after the second CT scan. Most of these patients underwent surgery (craniectomy) to relieve pressure on the brain. Nearly all patients who underwent further treatment developed neurological changes leading to immediate CT scanning.

Just two patients had a change in treatment based solely on routine repeated CT scans. Both of these patients received a drug (mannitol) to reduce intracranial pressure, rather than surgery

Decisions on CT Scans Can Be Based on Neurological Status

Dr. Almenawer and colleagues extended the same method to patients reported in 15 previous studies of CT scanning after mild head injury. Including the 445 new patients, the analysis included a total of 2,693 patients. Overall, 2.7 percent of patients had a change in management based on neurological changes. In contrast, just 0.6 percent had treatment changes based on CT scans only.

Bleeding within the brain is a potentially life-threatening condition, prompting routine repeated CT scans after even mild head injury. The researchers write, "Although CT scanners are very useful tools, in an era of diminishing resources and a need to justify medical costs, this practice needs to be evaluated." Each scan also exposes the patient to radiation, contributing to increased cancer risk.

The new study questions the need for routine repeated CT scans, as long as the patient's neurological condition is improving or stable. "In the absence of supporting data, we question the value of routine follow-up imaging given the associated accumulative increase in cost and risks," Dr. Almenawer and coauthors conclude.

Neurological examination is the "simple yet important" predictive factor leading to changes in treatment and guiding the need for repeat CT scanning after mild head injury, the researchers add. They emphasize that their findings don't necessarily apply to patients with more severe head injury.


'/>"/>

Contact: Connie Hughes
Connie.Hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

Related medicine news :

1. Routine mammograms may result in significant overdiagnosis of invasive breast cancer
2. Routine Kidney Disease Screening Not Worthwhile, Experts Say
3. Doctors Urge Routine Skin Screenings
4. U.S. Advisers Say No to Routine PSA Tests for Prostate Cancer
5. Routine care for Crohns disease in children should include measurement of bone age
6. Not Enough Data to Advise Routine Hearing Screens for Older People: Experts
7. Routine Screening Wont Cut Rates of Domestic Violence, Study Suggests
8. Routine electrocardiograms predict health risks for patients with atrial fibrillation
9. Routine blood test predicts prognosis in aggressive skin cancer
10. Routine Checkups Dont Cut Cancer, Heart Deaths: Study
11. Study questions reasons for routine pelvic exams
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/21/2017)... ... 2017 , ... Crossover Symmetry , an evidence based ... lifestyle company that provides Human Performance Training and education to tactical athletes. Together ... military officers and others in service through the development and conditioning of overall ...
(Date:4/21/2017)... ... April 21, 2017 , ... Northern California Medical ... Care Spring Symposium on April 1, 2017 in Santa Rosa. This well-attended annual ... healthcare providers an opportunity to learn about cutting edge treatments, to collaborate, share ...
(Date:4/21/2017)... ... April 21, 2017 , ... BrightStar Care Salt Lake City, a ... Care of Utah (APCUT) and has appointed Rex Wheeler as its new Director of ... for our agency and our ability to provide quality care to the community,” said ...
(Date:4/21/2017)... ... , ... During April 21-23, Super-Sod will join the vendor market of the ... everyone — from the avid gardener to the landscape admirer — during the three-day ... in a grand venue, and we are certainly looking forward to participating in this ...
(Date:4/21/2017)... ... April 21, 2017 , ... National pest management association survey conducted ... of bed bug infestations over the 5-year period. In 2015 10% or US$750 million ... of bed bug infested properties. , The health and economic consequences of bed ...
Breaking Medicine News(10 mins):
(Date:4/19/2017)... , April 19, 2017  Sorrento Therapeutics, Inc. ... clinical-stage biopharmaceutical company developing new treatments for cancer ... closing of its previously announced underwritten public offering ... a public offering price of $2.00 per share, ... offering expenses payable by Sorrento.  The net proceeds ...
(Date:4/18/2017)... -- Cardinal Health (NYSE: CAH ) today is ... share (EPS) guidance and providing a preliminary view on ... this morning,s announcement of the planned acquisition of Medtronic,s ... Cardinal Health now believes that fiscal 2017 ... bottom of its previous guidance range of $5.35 to ...
(Date:4/18/2017)... BLOOMINGTON, Minn. , April 18, ... IMMY ) ("Imprimis"), an ophthalmology-focused pharmaceutical company, and ... today announced the signing of a three-year exclusive ... will deploy a dedicated sales team to introduce ... U.S., primarily focused in 13 states in the ...
Breaking Medicine Technology: