Mild Head Injury: Criteria for Computed Tomography Scan

Background/Objective: Mild Head Injury (MHI) is the most commontype of head trauma, and forms a majority of the injuries seen in the traumaunit (65-85%).1 This study was aimed at using previously identifiedclinical risk factors to determine which category of patients with MHIwould not need to undergo Computed Tomography (CT). This may serveas cost saving measure to patients and hospitals likewise reduce collectiveradiation dose to the population.Methodology: A retrospective study conducted at the trauma unit of ateaching hospital situated in the Cape Metropole. CT scan images of 50patients aged 14 years and above who had MHI and undergone CTexamination were retrieved from the archive. Patients’ information, clinicalhistory and resultant CT findings were collated. Clinical risk factors werecorrelated with abnormal and normal CT scan findings. Data wereanalyzed using chi-square statistic at 95% confidence interval.Results: Twenty three (46%) of the patients had abnormal CT findings,and all presented with one or more of these risk factors; severe headache(10%), skull fracture (20%), scalp injury (6%), loss of consciousness(LOC)(8%) and intoxication(2%). The results were not statisticallysignificant when compared with the normal CT scans group. Four patients(8%) with no risk factors had normal CT scans. All the patients presentingwith the clinical risk factors, of nausea and vomiting 6% (n=50), seizures4% (n=50) had normal CT scan findings.Conclusion: Certain clinical risk factors can be used to suggest theprobability of abnormal CT scan in patients with MHI. Patients with norisk factors such as patients with confusion and disorientation are morelikely to have normal CT findings and may therefore be exempted from CTexamination. Further studies with larger sample size may be helpful invalidating these findings.