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Neurological emergencies — 3

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Diagnostic Tests in Neurology

Part of the book series: Diagnostic Tests Series ((DTS))

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Abstract

In patients with head injury, radiological investigation is primarily aimed at establishing which individuals have evidence of intracranial haemorrhage and might, therefore, respond to surgical intervention. The necessity for screening patients with a mild head injury by radiological procedures, remains controversial. In one study, the risk of developing an intracranial haematoma where orientation was preserved and no skull fracture visible was of the order of 1 in 6000, rising to a 1 in 4 risk if consciousness was impaired and a fracture present[1]. CT scanning of patients with disorientation and a fracture following head injury will allow early detection of two-thirds of all traumatic intracranial haemorrhage[1] (Fig. 13.1a,b). MRI scanning has some advantage over CT in the detection of post-traumatic cerebral contusion [2]. Whereas CT detects parenchymal, non-haemorrhagic lesions only in those with severe injury and persistent coma, MRI reveals white matter changes even where consciousness has been regained after 5 minutes[3]. T2-weighted images have proved most sensitive in detecting parenchymal abnormalities, the lesions appearing as areas of increased signal [3,4]. Indeed MRI detected brain abnormalities in 88% of patients with recent head injury in one series [3]. The final outcome in these individuals was not discussed and correlations between MRI change and sequelae from head injury have not yet been determined.

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  1. Department of Neurology, Charing Cross Hospital, London, UK

    G. D. Perkin

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© 1988 G.D. Perkin

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Perkin, G.D. (1988). Neurological emergencies — 3. In: Diagnostic Tests in Neurology. Diagnostic Tests Series. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-3320-1_13

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  • DOI: https://doi.org/10.1007/978-1-4899-3320-1_13

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-412-28400-7

  • Online ISBN: 978-1-4899-3320-1

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