FREQUENCY OF POSITIVE CT SCAN FINDINGS IN MINOR HEAD TRAUMA BASED ON NICE GUIDELINES

NICE Guidelines of Positive CT Scan Findings

Abstract

Objective: To determine the frequency of positive CT scan findings in cases of minor head injury with GCS score of 13-15 at presentation based on NICE guideline.
Study Design: Cross sectional study
Place and Duration of Study: Study was conducted in departments of Radiology CMH Rawalpindi and MH Rawalpindi from 10th Feb 2010 to 10th Aug 2010.
Subjects and Methods: One hundred and thirty five indoor and outdoor cases, fulfilling the inclusion criteria, reporting to the radiology department after head trauma, were included in the study after seeking written informed consent. Computerized tomography (CT scan) of the brain was done. Positive CT scan findings i.e. fracture, extradural, subdural and intraparenchymal hemorrhage were noted.
Results: Total number of patients studied in this study was 135 and evaluated after taking written consent from them. Out of total 135 patients 104 (77%) were males and 31(23%) were females. Positive CT scan findings were found in 10(7.4%) patients while 125(95.6%) patients had negative CT findings. Among patients having positive CT scan findings epidural hemorrhage was found in 2 (1.5%), intraparenchymal hemorrhage with fracture in 3 (2.2%), skull fracture in 3 (2.2%) and 1 (0.7%) patient had subdural hemorrhage.
Conclusion: CT scan is done in minor head trauma although results are often normal. NICE clinical guideline helps in identification and early management of head injury. The goal of implementing such guideline is to do CT scan only in those who are at risk of developing complications, thus minimizing the cost of CT scanning as well as strain on emergency neurology and radiology departments.