scholarly journals On site computed tomography in the district general hospital for severe head injury.

1999 ◽  
Vol 16 (1) ◽  
pp. 75-76
Author(s):  
N E Scholes
Neurosurgery ◽  
1980 ◽  
Vol 7 (1) ◽  
pp. 14-22 ◽  
Author(s):  
K. J. van Dongen ◽  
R. Braakman

Author(s):  
Dr. Dileep Kumar Jha ◽  
Dr. Rajnikant Narsinhbhai Chauhan

Introduction: In human body there are many causes of the injuries. Among all the injuries head injury is also one of the most important injuries which may cause morbidity and mortality. Craniocerebral injuries or Traumatic brain injury (TBI) is defined as any structural skull traumatic injury with alterations of cerebral physiology as a result of an external force either in the form of chemical energy, mechanical energy, electrical energy or thermal heating. Globally craniocerebral injuries or Traumatic brain injury (TBI)is cause of disability in young patients, especially those  <40 years of age. TBI is classified as mild, with most showing adequate and quick recovery. Nevertheless there are some kinds of TBI which showed persistent disabling symptoms that interrupt with their normal daily routine activities. Brain imaging is very important for the patients who suffer traumatic brain injury. In the emergency services Computed tomography (CT) is recommended as first assessment that provides initial information and diagnosis to identify the need of surgery. It also helps in the following of the patient and the evolution of pathology. Many studies suggest that CT can be used to predict patient outcomes. Computed tomography (CT) is an imaging technique which uses as dynamics of injected contrast material, allows rapid quantitative and qualitative evaluation of cerebral perfusion by generating cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) maps providing clinically important information with stroke subarachnoid hemorrhage (SAH)and head injury. Aim: The main aim of this study is to evaluate the computed tomography findings sustaining head injury and role of computed tomography scan in head injury. Material and Methods: During the study total 90 patients with head injury were included with different age group from 20 to 70 years old. Glasgow coma score (GCS) range 4–15 (mild head injury: GCS >14; moderate head injury: GCS = 9–13; severe head injury GCS <8) were also included in this study. For all the patients with head injury Computed tomography (CT) image were performed with siemen's somatom spirit dual slice spiral CT machine and a protocol of contiguous axial 5-mm sections through the posterior fossa and a contiguous 10 mm axial sequential scans for the rest of the brain and thinner cuts were also taken whenever required. For visualize any fractures of the skull bone algorithms with wide window settings were studied. After initial resuscitation, severity of the cranio-cerebral trauma was graded with the help of Glasgow Coma Scale (GCS) into mild head injury (GCS13- 15), moderate head injury (GCS 9-12) and severe head injury (GCS 3-8). Result: Among total patients sixty five (72.2%) patients were male and twenty five (27.8 %) were female with age range from 20 to 70 years old. In the age group 31-50 year group showed highest frequency of head trauma. The most common causes of head injury were RTA (65.6%) followed by fall injuries (20%) and physical assaults (14.4%). Among patients with head injuries Loss of consciousness and vomiting were the commonest clinical features brought to emergency. Out of 90 cases 59 (65.5%) cases showed mild head injury followed by 14(15.6%) cases sustained moderate head injury and 17(18.9%) had severe head injury. In all types of severity of head injury RTA was the prime etiological factor. Out of total cases 31(34.4%) had normal CT findings and 59(65.6%) had abnormal CT findings. Abnormal CT findings were seen in 59(65.6%) sustaining mild head injury and in all the patients with moderate and severe head injury. Out of 90 cases 13 cases with severe head injury had mortality. The most common mode of injury to cause the mortality was RTA. Five patients with severe head injury also had cervical spine injury Conclusion: This study concludes that use of CT in head trauma can finds high prevalence of head trauma related to CT. Therefore CT should be done when clinically necessary that helps to reduce cost and avoids unnecessary exposure to radiation. Keywords: Head injury, Traumatic brain injury (TBI), computed tomography (CT), Glasgow coma scale (GCS)


2012 ◽  
Vol 94 (2) ◽  
pp. 102-107 ◽  
Author(s):  
J Weir-McCall ◽  
A Shaw ◽  
A Arya ◽  
A Knight ◽  
DC Howlett

INTRODUCTION While there are a lot of data on the accuracy of computed tomography (CT) in diagnosing specific causes of an acute abdomen, there is very little information on the accuracy of CT in the acute general surgical admissions workload. We look at the diagnostic accuracy of CT in patients presenting with an acute abdomen who ultimately required a laparotomy. METHODS Patients who underwent an emergency laparotomy between 2008 and 2010 at Eastbourne District General Hospital with pre-operative CT on the same admission were included in the study. The CT report was compared with the laparotomy and histology findings and, where a discrepancy existed, the original imaging was reviewed by a senior consultant blinded to the original report and laparotomy findings. RESULTS A total of 196 emergency laparotomies were performed over the 2–year period, with 112 patients undergoing pre-operative CT. Fifteen patients were excluded from the study due to missing notes. In the remaining 97 patients, 80 CT reports correlated with the final operative diagnosis, giving a diagnostic accuracy of 82%. Of these, the on-call registrar was the initial reporter in 37 scans, with a diagnostic accuracy of 78%. On review of the CT by a second consultant, this increased to 90 correlations, yielding an accuracy of 93%. Delay between CT and the operation did not significantly alter diagnostic accuracy, nor was there any statistically significant reduction in accuracy in reports issued by on-call registrars. CONCLUSIONS On first reporting, CT misses 18% of diagnoses that ultimately require operative intervention. Reducing the threshold for obtaining a second consultant radiologist review significantly improves the diagnostic accuracy to 93%.


2019 ◽  
Vol 89 (5) ◽  
pp. 541-545
Author(s):  
William Lynn ◽  
Bhamini Vadhwana ◽  
Daniel J. Bell ◽  
Rudi Borgstein ◽  
George Demetriou ◽  
...  

2007 ◽  
Vol 42 (11) ◽  
pp. 1903-1906 ◽  
Author(s):  
Gemma Claret Teruel ◽  
Antonio Palomeque Rico ◽  
Francisco José Cambra Lasaosa ◽  
Albert Català Temprano ◽  
Antoni Noguera Julian ◽  
...  

2017 ◽  
Vol 19 (1) ◽  
pp. 76-79 ◽  
Author(s):  
Sahra Durnford ◽  
Harry Bulstrode ◽  
Andrew Durnford ◽  
Aabir Chakraborty ◽  
Nicholas T Tarmey

We report the case of a 69-year-old man admitted to the emergency department of a UK district general hospital with an extradural haematoma following closed head injury. He deteriorated rapidly before transfer to the regional neurosurgical centre and was treated with decompression of the extradural haematoma through an EZ-IO™ intraosseous needle in our department, with telephone guidance from the neurosurgeon. We believe this to be the first reported use of this technique in a district general hospital.


2021 ◽  
Vol 8 (10) ◽  
pp. 3075
Author(s):  
A. K. Chaurasia ◽  
Lalit Dhurve ◽  
Rajneesh Gour ◽  
Rajpal Kori ◽  
Avias K. Ahmad

Background: Traumatic brain injury is one of most common cause of death in road traffic accident. Most of these classified as mild injury, with approximately 20% classified as moderate to severe. Approximate 50% of the 150,000 trauma deaths every year are caused by head injury.Methods: A prospective cross-sectional study was conducted on 150 patients with a head injury admitted in the Hamidia hospital, Bhopal. The assessment of the severity of head injury using Glasgow coma scale (GCS) at the time of admission, follow up on 5 days and 15 days respectively. The collected data were transformed into variables, coded and entered in Microsoft excel. Data were analyzed and statistically evaluated using statistical package for the social sciences (SPSS)-PC-21 version.Results: Out of 150, a total of 115 patients had no midline shift while 35 patients were having midline shift. Severe head injury patients (GCS 3-8) were having more morbidity and mortality. Moderate head injury (GCS 9-13) was associated with good prognosis and low mortality. A greater degree of midline shift of (more than 5 mm) is indicated severe head injury and is significantly associated with morbid outcome and higher mortality.Conclusions: In our study, road traffic accidents is the most common cause of head injury, with males being affected more than females. The degree of midline shift on computed tomography (CT) scan head in patients with head injuries was found to be significantly associated with high mortality and morbidity.


Neurosurgery ◽  
1987 ◽  
Vol 20 (3) ◽  
pp. 396-402 ◽  
Author(s):  
Barbara P. Uzzell ◽  
Carol A. Dolinskas ◽  
Randall F. Wiser ◽  
Thomas W. Langfitt

Author(s):  
Bibek Khadka ◽  
Prabin Kumar Deka ◽  
Alina Karki

Background: Head injury is considered as a major health problem that is a frequent cause of death and disability and makes considerable demands on health services. CT remains essential for detecting lesions that require immediate neurosurgical intervention as well as those that require in-hospital observation and medical management.Objectives: To evaluate the computed tomography findings in patients sustaining head injury and to emphasize the importance of computed tomography scan in head injury.Methodology: The study was conducted for the period of one year .It comprised a total number of eighty patients presenting to the emergency room(ER) with head injury and were evaluated by CT scan of head using siemens somatom dual slice spiral CT machine.Results: the study showed overall male to female ratio as 2.6:1. Head injury was most common in 31-50years of age group. Road traffic accidents (RTA) was the commonest mode of injury seen in 65% of patients. Loss of consciousness followed by vomiting and seizures were the common clinical presentations in head trauma patients respectively. According to Glasgow coma scale( GCS), most of the patients (68.8%)sustained mild head injury( GCS13-15). Most common abnormal CT findings were skull fractures 39(48.8%), extradural hematoma 31 ( 38.8%), subdural hematoma 21(26.2%) ,contusions 21(26.2%), subarachnoid hemorrhage14 ( 17.5%) and pneumocephalous 13 (16.2%) respectively. Linear skull fracture was the commonest among all other skull fractures. Patients sustaining severe head injury were mostly due to RTA (77%). The highest mortality was seen in patients with severe head injury (GCS 3-8). 5% also had cervical spine injury.Conclusion: CT is the most comprehensive diagnostic modality for accurate localization of the site of injury in craniocerebral trauma. The early and timely diagnosis of the precise lesion by CT not only had the substantial impact over instituting appropriate treatment and timely surgical intervention but also helped in predicting the ultimate outcome.Journal of Manmohan Memorial Institute of Health Sciences Vol. 2 2016 p.45-52


Sign in / Sign up

Export Citation Format

Share Document