Analysis of Repeated CT Scan Need in Blunt Head Trauma

Background. Computed tomography (CT) is a vital tool in the workup of patients with closed head trauma. The aim of this study was to investigate the necessity of serial CT scans in patients with blunt head trauma. Methods. This is a retrospective study analyzing trauma patients between January and June 2012. Data were analysed by using frequencies, Kolmogorov-Smirnov (K-S), and Chi-square tests. Results. Of the total 351 control Head CTs, it was seen there were no different in 346 (98.6%). In CTs of another 3 patients (0.9%), there were increasing or new, in the other 2 (0.6%) there was a decrease in the pathology present. Of 24 (6.8%) patients who had a hemorrhage in the first CT, there was an increase in the hemorrhage in one of them, a decrease of the pathology in 2 of them. Of 27 (7.7%) patients who had fracture in first CT, 2 had a new intracranial hemorrhage. The relation of the results between the first and second CTs were statistically significant ( , test). Conclusion. Repeated CT scans after 6 hours in EDs observation rooms are not necessary if first CT is normal in most situations. Special attention may be needed in patients with an underlying chronic disease. 1. Introduction Blunt head trauma is a common pathology seen in emergency departments (EDs). Initial evaluation includes a careful neurological examination and computed tomography (CT) scans of the brain [1]. CT scans is the represent the initial study of choice in current practice to determine the type, extent and severity of traumatic brain injury as well as to determine the management protocol [2]. The role of the initial brain CT scan and of unscheduled repeat brain CTs when a neurological deterioration occurs is well established [3]. However, there are no guidelines on the necessity for or the value of a repeat CT scan. There are reports emphasizing the importance of serial CT scans in patients with head trauma, while others feel it to be unnecessary in most patients. Nevertheless, patients who present with head trauma often receive repeat CT scans to rule out the progression of their head injury. The aim of this study was to determine whether serial CT scans are necessary to identify the incidence of delayed positive findings in patients who present to the ED with blunt head trauma. 2. Methods This is a retrospective study analyzing trauma patients between January and June 2012 in Marmara University Pendik Research and Training Hospital. The study was approved by the Institutional Review Board. In our emergency department, trauma patients of all ages are first seen by emergency