Korean J Neurotrauma.  2014 Apr;10(1):26-30. 10.13004/kjnt.2014.10.1.26.

Serial Brain CT Scans in Severe Head Injury without Intracranial Pressure Monitoring

• Shin DS
• Hwang SC
• Kim BT
• Jeong JH
• Im SB
• Shin WH

• KMID: 2156094
• DOI: http://doi.org/10.13004/kjnt.2014.10.1.26

Abstract

OBJECTIVE
The intracranial pathologies after head trauma should be usually progressed. It is clearly visualized in the non-invasive brain CT. The invasive monitor such as intracranial pressure (ICP) monitoring may be accompanied with the complications. This study aims whether the patients with severe head injury could be managed with serial CT scans.
METHODS
The medical records of 113 patients with severe head injury in the prospectively enrolled trauma bank were retrospectively analyzed. After the emergency care, all the patients were admitted to the intensive care unit for the aggressive medical managements. Repeat brain CT scans were routinely taken at 6 hours and 48 hours after the trauma. ICP monitoring was restrictively applied for the uncertain intracranial pressure based on the CT. The surgical intervention and the mortality rate were analyzed.
RESULTS
Immediate surgical intervention after the initial CT scan was done in 47 patients. Among the initially non-surgical patients, 59 patients were managed with the serial CT scans and 7 with the ICP monitoring. Surgical interventions underwent eventually for 10 patients in the initially non-surgical patients; 1 in the ICP monitoring and 9 in the serial CT. The mortality rate was 23.7% in the serial brain CT and 28.6% in the ICP monitoring. There was no statistical difference between two groups in the aspect of mortality (p=0.33).
CONCLUSION
Serial CT scans in time could be a good way to monitor the intracranial progression in the severe head injury and reduce the implantation of an invasive ICP probe.

Keyword

CT; Severe head injury; Intracranial pressure monitoring; Mortality

MeSH Terms

Brain*
Craniocerebral Trauma*
Emergency Medical Services
Humans
Intensive Care Units
Intracranial Pressure*
Medical Records
Mortality
Pathology
Prospective Studies
Retrospective Studies
Tomography, X-Ray Computed*

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