A report appearing in Neurosurgery reports that a patient’s neurological condition should be the basis for repeated computed tomography (CT) scans show bleeding within the brain following mild head injury.
“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,” Saleh Almenawer, MD, study leader, notes.
Almenawer and colleagues of McMaster University, Ont, Canada, reportedly used their hospital’s trauma database in order to identify 445 adult patients with mild head injury who exhibited evidence of intracranial hemorrhage (ICH) on an initial CT scan. According to researchers, in the trauma centers it is standard procedure to schedule a second CT scan within 24 hours following the detection of ICH, in order to ensure that the bleeding has not progressed.
The researchers note that they reviewed how many patients required 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.
The results suggest that 5.6% of the patients required a change in treatment following the second CT scan. The results also indicate that only two patients required a change in treatment based solely on routine repeated CT scans.
In response to the results, Almenawer and colleagues question the value of routine follow-up imaging, “follow-up imaging given the associated accumulative increase in cost and risks.” However, researchers add that the findings may not necessarily apply to patients with more severe head injury.
Source: Wolters Kulwer Health
