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Computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and/or amnesia, Glasgow Coma Scale 15 and no focal neurological deficit

Background: South Africa is a developing country with limited resources. Currently, in our institution, patients who have suffered a minor head injury with a Glasgow Coma Scale (GCS) 15, loss of consciousness (LOC) and amnesia obtain a computed tomography (CT) scan, regardless of the cost that is in...

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Main Author: Singata, Chuma
Other Authors: Candy, Sally
Format: Thesis
Language:English
Published: Division of Radiology 2018
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access_status_str Open Access
author Singata, Chuma
author2 Candy, Sally
author_browse Candy, Sally
Singata, Chuma
author_facet Candy, Sally
Singata, Chuma
author_sort Singata, Chuma
collection Thesis
description Background: South Africa is a developing country with limited resources. Currently, in our institution, patients who have suffered a minor head injury with a Glasgow Coma Scale (GCS) 15, loss of consciousness (LOC) and amnesia obtain a computed tomography (CT) scan, regardless of the cost that is incurred by the use of this limited resource. Applying recommendations in developing countries requires consideration of resource limitations and patient burden. Objective: Our objectives were twofold: 1. To determine the number of abnormalities found on routine head CTs in patients who have a history of LOC and amnesia/PTA post trauma, but with a normal mental status (GCS 15) on presentation to the trauma unit. 2. To determine the clinical value of routine CT scan of the head in patients who have suffered minor head injury with GCS 15, LOC and amnesia. Methods: The CT scan reports of 460 patients with minor head injury, GCS 15, LOC and amnesia were reviewed retrospectively in the radiology unit of Groote Schuur Hospital between the years 2012 and 2014. These patients were assessed by the trauma doctor and referred to the radiology department for a CT scan of the head. Reports had been prepared and verified by a radiology specialist or senior registrar. Results: The findings on CT were categorized as significant and insignificant. A total of 33 patient reports (7%) met the criteria of significant findings that required neurosurgical intervention. (CI 4, 7-9, 6). 320 patients (70%) had normal findings while 107 patients (23%) had insignificant findings. Conclusion: CT scan of the head in minor head injury patients with normal mental status (GCS 15) is recommended even in the face of the limited resource in view of our study results.
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
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spelling oai:open.uct.ac.za:11427/27086 Computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and/or amnesia, Glasgow Coma Scale 15 and no focal neurological deficit Singata, Chuma Candy, Sally Radiology Background: South Africa is a developing country with limited resources. Currently, in our institution, patients who have suffered a minor head injury with a Glasgow Coma Scale (GCS) 15, loss of consciousness (LOC) and amnesia obtain a computed tomography (CT) scan, regardless of the cost that is incurred by the use of this limited resource. Applying recommendations in developing countries requires consideration of resource limitations and patient burden. Objective: Our objectives were twofold: 1. To determine the number of abnormalities found on routine head CTs in patients who have a history of LOC and amnesia/PTA post trauma, but with a normal mental status (GCS 15) on presentation to the trauma unit. 2. To determine the clinical value of routine CT scan of the head in patients who have suffered minor head injury with GCS 15, LOC and amnesia. Methods: The CT scan reports of 460 patients with minor head injury, GCS 15, LOC and amnesia were reviewed retrospectively in the radiology unit of Groote Schuur Hospital between the years 2012 and 2014. These patients were assessed by the trauma doctor and referred to the radiology department for a CT scan of the head. Reports had been prepared and verified by a radiology specialist or senior registrar. Results: The findings on CT were categorized as significant and insignificant. A total of 33 patient reports (7%) met the criteria of significant findings that required neurosurgical intervention. (CI 4, 7-9, 6). 320 patients (70%) had normal findings while 107 patients (23%) had insignificant findings. Conclusion: CT scan of the head in minor head injury patients with normal mental status (GCS 15) is recommended even in the face of the limited resource in view of our study results. 2018-01-30T10:21:37Z 2018-01-30T10:21:37Z 2017 Master Thesis Masters MMed http://hdl.handle.net/11427/27086 eng application/pdf Division of Radiology Faculty of Health Sciences University of Cape Town
spellingShingle Radiology
Singata, Chuma
Computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and/or amnesia, Glasgow Coma Scale 15 and no focal neurological deficit
thesis_degree_str Master's
title Computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and/or amnesia, Glasgow Coma Scale 15 and no focal neurological deficit
title_full Computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and/or amnesia, Glasgow Coma Scale 15 and no focal neurological deficit
title_fullStr Computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and/or amnesia, Glasgow Coma Scale 15 and no focal neurological deficit
title_full_unstemmed Computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and/or amnesia, Glasgow Coma Scale 15 and no focal neurological deficit
title_short Computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and/or amnesia, Glasgow Coma Scale 15 and no focal neurological deficit
title_sort computed tomography findings in patients with minor head trauma presenting with a history of loss of consciousness and or amnesia glasgow coma scale 15 and no focal neurological deficit
topic Radiology
url http://hdl.handle.net/11427/27086
work_keys_str_mv AT singatachuma computedtomographyfindingsinpatientswithminorheadtraumapresentingwithahistoryoflossofconsciousnessandoramnesiaglasgowcomascale15andnofocalneurologicaldeficit