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Indications for CT scanning in minor head injuries: A review
- Department of General and Hand Surgery, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland
open access
Abstract
To determine indications for performing head CT following minor head injuries, which allow reducing number of imaging.
Materials and methodsBased on 15 articles dedicated to this topic, the clinical decision rules were systematically analysed.
ResultsThe Canadian Computed Tomography Head Rule was found to be the most reliable instrument meeting these criteria, characterised by excellent sensitivity of 100% and fairly good specificity of 48–77%. Remaining scales, although very sensitive, showed poor ability to reduce number of “unnecessary” CT scans. Features most predictive for intracranial injuries included: disorientation, abnormal alertness, somnolentia and neurological deficits. Patients with no loss of consciousness and in normal physical condition need only clinical assessment. Indications to head CT scanning are determined by decision rules presented in the article.
ConclusionUse of clinical decision rules may have effect on reducing number of head CT scanning performed “just in a case”.
Abstract
To determine indications for performing head CT following minor head injuries, which allow reducing number of imaging.
Materials and methodsBased on 15 articles dedicated to this topic, the clinical decision rules were systematically analysed.
ResultsThe Canadian Computed Tomography Head Rule was found to be the most reliable instrument meeting these criteria, characterised by excellent sensitivity of 100% and fairly good specificity of 48–77%. Remaining scales, although very sensitive, showed poor ability to reduce number of “unnecessary” CT scans. Features most predictive for intracranial injuries included: disorientation, abnormal alertness, somnolentia and neurological deficits. Patients with no loss of consciousness and in normal physical condition need only clinical assessment. Indications to head CT scanning are determined by decision rules presented in the article.
ConclusionUse of clinical decision rules may have effect on reducing number of head CT scanning performed “just in a case”.
Keywords
Head injury, Head computed tomography, Clinical decision rule
Title
Indications for CT scanning in minor head injuries: A review
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Review Article
Pages
52-57
Page views
334
Article views/downloads
349
DOI
10.1016/j.pjnns.2014.12.007
Bibliographic record
Neurol Neurochir Pol 2015;49(1):52-57.
Keywords
Head injury
Head computed tomography
Clinical decision rule
Authors
Andrzej Żyluk