Variables that Predict Significant Intracranial Damage in Mild Head Injury
Keywords:
Mild head injuries, vomiting, CT scan brainAbstract
Objective: To identify patients, at risk of intracranial complications, after mild head injury.
Study Design: It was an observational study.
Place and Duration: Patients received at the emergency department or OPD or referred to Pakistan institute of Medical Sciences, Islamabad were included in the study. Pakistan institute of Medical Sciences is a tertiary care hospital that recruits patients from Punjab and northern areas. The data was collected over a period of six mon-ths from 1st August 2008 till 31st January 2009. A total of 206 patients were included in our study.
Methodology: Data were analyzed relating to a consecutive series of 206 patients who presented to the emer-gency department of Pakistan Institute of Medical Sciences, Islamabad. Data was collected through non-pro-bability convenience sampling. Characteristics studied, were age, gender, mode of trauma, level of consciousness and CT scan brain findings.
Result: Our study included 206 patients with mild head injury. Their age ranged from 1 to 90 years with a mean age of 32.06 ? 19.86 years. Maximum patients (59 patients 28.6%) were in the age range of 21 – 30 years. Only 34 (16.5%) patients were above 50 years of age and 26 (12.6%) were below the age of 10 years.163 (79%) were males and remaining 43 (21%) were females. 124 (60.2%) were due to road traffic accidents, 62 (30.1%) were due to falls, 18 (8.7%) were assault injuries and 2 (0.9%) were sports injuries. All patients had a GCS score of 13 – 15; with a mean score of 14.35 ? 0.902. Majority of the patients (132 patient, 64%) had a GCS of 15, 14 (6.8%) had a GCS of 14 and 60 (29%) had a GCS of 13. 127 (61.7%) patients presented with vomiting after head injury and 79 (38.3%) patients did not vomit. 49 (23.8%) vomited once and 78 (37.9%) vomited on multiple occasions. CT scan was done without contrast in all patients. It was reported as normal in 68 (33%) patients, 39 (18%) had extradural hematoma, 15 (7.3%) had subdural hematoma, 4 (1.9%) showed intracerebral hemor-rhage, 30 (14.6%) had cerebral contusion, 6 (2.9%) had subarachnoid hemorrhage, 20 (9.7%) had diffuse axonal injury and 9 (11.7%) patients had skull fracture.
Conclusion: Our study was conducted to derive and validate a set of criteria that could be used to identify patients with minor head injury in whom CT could be forgone. It concluded that men, in their twenties, suffered from mild head injury, most commonly from a road traffic accident and were more likely to have an intracranial surgical lesion, such as an extra dural haematoma
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