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Journal of The Korean Society of Emergency Medicine 1994;5(1): 5-16. |
| THE VALUE OF COMPUTED TOMOGRAPHIC SCANS FOR PATIENTS WITH LOW-RISK HEAD INJURIES |
| Jung Bae Park, CheoI Wan Park, Keun Lee |
| Departtment of Emergency Medicine, Chung Ang Gil Hospital, Inchon, Korea |
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Published online: July 31, 1994. |
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| ABSTRACT |
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The determination that a particular head injury is low-risk is usually made clinically. Obser vation at home or in the hospital has been the usual treatment for such patients. Recent reports of relatively high morbidity among patients with low-risk head injury in other countries sug gest the need for advancement in diagnostic criteria. A retrospective review of 1202 patients admitted to Chung Ang Gil Hospital between January 1992 and June 1992 who had a Glasgow coma scale(GCS) score of 13 to 15 on admission and who experienced a brief loss of conscious ness or amnesia after the injury ，was performed to evaluate the benefit of computed tomographic(CT) scanning of the head.
In 14.9% of patients abnormalities were seen on the initial CT scan and 5.7% required sur gery. Among the 831 patients with GCS 15，10.3% had abnormalities on the CT scan and 3.4% required neurosurgical operation. In cases of GCS 14，an initial CT scan showed abnormality in 19.5% and 8.1% needed operation. Only 4 of the 1022 patients with normal CT scans on admission showed subsequent deterioration and required operation. These figures suggest that history and neurologic examination alone are not adequate to assess head injury or severity of risk and that the addition of a CT scan greatly imηroves patient assessmen t. Patients with normal CT scans and with GCS 14 or 15 could be considered for observation at home because their chance of deterioration is so low，allowing hospital personnel to devote their full attention to more seriously injured patients. |
| Key words:
Low risk head injuries. Computed tomographic scanning of head |
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