Complicated Mild Traumatic Brain Injury and the Need for Imaging Surveillance

Abstract Objective to evaluate the need for repeat head CT in patients with complicated mild traumatic brain injury (cmTBI) determined non-operative after the first head CT Methods 380 patients with mild TBI and a positive head CT not needing surgery were included. Changes between first and second head CT were categorized as decreased, increased or stable. Results Three patients required neurosurgical intervention (0.8%) after the second CT. There were no significant differences in demographics including age, gender, alcohol consumption, anticoagulation status, time between first and second CT, GCS at admission and discharge, and incidence of SAH, EDH, contusion or skull fractures between the operated and non-operated groups. All patients in the operated group had SDH compared to 40.8% in the non-operated group (p = 0.07). All operated patients demonstrated symptoms of neurological worsening after initial head CT, compared to 2.7% in the non-operated group (p