Predictors of positive CT scans in the elderly trauma patients with minor head injury. Case reports and review of the literature

  • Nikolaos Syrmos
  • Ilias Gramatikopoulos
  • Vasilios Valadakis
  • Konstantinos Grigoriou
  • Dimitrios Arvanitakis
Open Access
Poster presentation
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Keywords

Emergency Room Head Injury Trauma Patient Glasgow Coma Scale Bone Fracture 

Background

The purpose of this study was to determine whether there were characteristics of the trauma patient with a minor head injury. Glasgow Coma Scale (GCS) of 13-15, that would predict a positive cerebral CT scan.

Materials and methods

An analysis of 300 patients with potential head injuries transported to our department was performed. The following characteristics were analyzed as possible predictors: 1. scene GCS, 2. emergency room GCS, 3. a change in GCS from scene to emergency room, 4. loss of consciousness, 5. focal neurological deficit.

Results

50 per cent (150/300) of the patients underwent CT scanning of the head. CT scans were positive in 5,3 per cent (16/300) of the total group and 10.6 per cent (16/150) of those who underwent CT scanning. In the patients without LOC and ER-GCS of 13-15, all CT scans were negative.

Conclusions

Of all the patients with positive CT scans, 4 underwent emergent craniotomy: 2 for a depressed skull fracture with underlying contusion, and 2 for a temporal bone fracture and an epidural hematoma. Both patients had LOC and SC-GCS and ER-GCS of 15. We present our cases and finally we performed a review of the literature.

References

  1. 1.
    Livingston DH, Loder PA, Hunt CD: Minimal head injury: is admission necessary?. Am Surg. 1991, 57 (1): 14-7.PubMedGoogle Scholar
  2. 2.
    Borczuk P: Predictors of intracranial injury in patients with mild head trauma. Ann Emerg Med. 1995, 25 (6): 731-6. 10.1016/S0196-0644(95)70199-0.CrossRefPubMedGoogle Scholar
  3. 3.
    Dacey RG, Alves WM, Rimel RW, Winn HR, Jane JA: Neurosurgical complications after apparently minor head injury. Assessment of risk in a series of 610 patients. J Neurosurg. 1986, 65 (2): 203-10.CrossRefPubMedGoogle Scholar

Copyright information

© Syrmos et al.; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

Authors and Affiliations

  • Nikolaos Syrmos
    • 1
  • Ilias Gramatikopoulos
    • 1
  • Vasilios Valadakis
    • 1
  • Konstantinos Grigoriou
    • 1
  • Dimitrios Arvanitakis
    • 1
  1. 1.Neurosurgical Department-Venizeleio General HospitalHeraklionCrete

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