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:2/17/2017)... ... 2017 , ... Like most hospitals across the nation, Onslow Memorial Hospital is ... Hospital Readmission Reduction Program (HRRP), the return of a patient to the hospital within ... nation. While many providers are struggling to leverage limited resources and technology, Onslow Memorial ...
(Date:2/17/2017)... ... February 17, 2017 , ... The Mason ... to families and business owners in and around the Hampton Roads metropolitan region, ... prevent all forms of domestic violence. , There are multiple categories of domestic ...
(Date:2/16/2017)... ... February 17, 2017 , ... Harsha Chigurupati knows the ... research, development and clinical trials, the founder of Chigurupati Technologies has invented India’s ... FDA approved ingredients that when infused into alcohol, protect the consumer’s liver and ...
(Date:2/16/2017)... ... February 17, 2017 , ... Teaching nursing care of vulnerable children is the ... (pediatrics) is being created with the support of the Hearst Foundations. An initiative of ... will address what has been identified as a critical gap in preparing the next ...
(Date:2/16/2017)... ... February 16, 2017 , ... As a reflection of ... NWH has achieved Magnet® recognition for the second time, announced by ... American Nurses Credentialing Center’s Magnet Recognition Program® distinguishes organizations that meet rigorous standards ...
Breaking Medicine News(10 mins):
(Date:2/17/2017)... , Feb 17, 2017 Research and Markets ... Business Report" report to their offering. ... The report provides separate comprehensive analytics for the US, ... , Asia-Pacific , Latin America ... the period 2015 through 2022. Also, a six-year historic analysis is provided ...
(Date:2/17/2017)... ST. LOUIS , Feb. 17, 2017   ... hospitals, has announced a new partnership with Engage ... the United States . FormFast will serve ... part of Engage,s implementations with MEDITECH .  ... that provides essential functionality to complement and enhance the ...
(Date:2/17/2017)... 17, 2017 On Thursday, February ... edged lower at the closing bell, while the Dow ... 20,000 benchmark. Moreover, five out of nine sectors ended ... yesterday,s market sentiment, Stock-Callers.com assessed the following Medical Appliances ... (NYSE: SNN ), ABIOMED Inc. (NASDAQ: ...
Breaking Medicine Technology: