Consideration of Brain CT Imaging Standard for Mild Head Injuries
It has been reported that various clinical criteria indicate computed tomography (CT) examination for mild head injury (MHI). However, the decision to perform CT for MHI largely depends on the physician. Data on severe head injuries is available in sources such as the Japan Neurotrauma Data Bank, bu...
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| Veröffentlicht in: | Neurologia Medico-Chirurgica 2024/06/15, Vol.64(6), pp.247-252 |
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| creator | KUMAGAWA, Takahiro OTAKI, Ryo MAEDA, Takeshi SHIJO, Katsunori YOSHINO, Atsuo |
| description | It has been reported that various clinical criteria indicate computed tomography (CT) examination for mild head injury (MHI). However, the decision to perform CT for MHI largely depends on the physician. Data on severe head injuries is available in sources such as the Japan Neurotrauma Data Bank, but only a few data has been collected on MHI. A total of 1688 patients with MHI (Glasgow Coma Scale 14 and 15) treated at our hospital from June 2017 to May 2019 were reviewed. CT was performed in 1237 patients (73.28%), and intracranial hemorrhage was detected in 50 patients. Three patients deteriorated, and all were surgically treated. Statistical analysis of the presence or absence of acute intracranial hemorrhage and "risk factors for complications of intracranial lesions in MHI" showed significant differences in unclear or ambiguous accident history (p = 0.022), continued post-traumatic amnesia (p < 0.01), trauma above the clavicles including clinical signs of skull fracture (skull base or depressed skull fracture) (p = 0.012), age |
| doi_str_mv | 10.2176/jns-nmc.2023-0297 |
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However, the decision to perform CT for MHI largely depends on the physician. Data on severe head injuries is available in sources such as the Japan Neurotrauma Data Bank, but only a few data has been collected on MHI. A total of 1688 patients with MHI (Glasgow Coma Scale 14 and 15) treated at our hospital from June 2017 to May 2019 were reviewed. CT was performed in 1237 patients (73.28%), and intracranial hemorrhage was detected in 50 patients. Three patients deteriorated, and all were surgically treated. Statistical analysis of the presence or absence of acute intracranial hemorrhage and "risk factors for complications of intracranial lesions in MHI" showed significant differences in unclear or ambiguous accident history (p = 0.022), continued post-traumatic amnesia (p < 0.01), trauma above the clavicles including clinical signs of skull fracture (skull base or depressed skull fracture) (p = 0.012), age <60 years (p < 0.01), coagulation disorders (p < 0.01), and alcohol or drug intoxication (p < 0.01). The 453 patients who did not satisfy these risk factors included only one patient with intracranial hemorrhage, so the negative predictive value was 99.78%. This study shows that the "risk factors for complications of intracranial lesions in MHI" are effective criteria for excluding acute intracranial hemorrhage and CT should be actively considered for patients with the above factors that showed significant differences.</description><identifier>ISSN: 0470-8105</identifier><identifier>EISSN: 1349-8029</identifier><identifier>DOI: 10.2176/jns-nmc.2023-0297</identifier><identifier>PMID: 38719579</identifier><language>eng</language><publisher>Japan: The Japan Neurosurgical Society</publisher><subject>acute intracranial lesions ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amnesia ; Brain Concussion - diagnostic imaging ; Brain injury ; Child ; Computed tomography ; computed tomography (CT) ; Craniocerebral Trauma - complications ; Craniocerebral Trauma - diagnostic imaging ; Female ; Fractures ; Glasgow Coma Scale ; Head injuries ; Hemorrhage ; Humans ; Intoxication ; Intracranial Hemorrhages - diagnostic imaging ; Intracranial Hemorrhages - etiology ; Japan ; Male ; Middle Aged ; mild head injury ; Neuroimaging ; Original ; Patients ; Retrospective Studies ; Risk Factors ; Skull ; Statistical analysis ; Tomography, X-Ray Computed ; Trauma ; Young Adult</subject><ispartof>Neurologia medico-chirurgica, 2024/06/15, Vol.64(6), pp.247-252</ispartof><rights>2024 The Japan Neurosurgical Society</rights><rights>2024. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c693t-e81c13af623759dc746269dd8735855ba04a655be978fa51ea32b983734b2dae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230873/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230873/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1877,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38719579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KUMAGAWA, Takahiro</creatorcontrib><creatorcontrib>OTAKI, Ryo</creatorcontrib><creatorcontrib>MAEDA, Takeshi</creatorcontrib><creatorcontrib>SHIJO, Katsunori</creatorcontrib><creatorcontrib>YOSHINO, Atsuo</creatorcontrib><creatorcontrib>Department of Neurological Surgery</creatorcontrib><creatorcontrib>Nihon University School of Medicine</creatorcontrib><title>Consideration of Brain CT Imaging Standard for Mild Head Injuries</title><title>Neurologia Medico-Chirurgica</title><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><description>It has been reported that various clinical criteria indicate computed tomography (CT) examination for mild head injury (MHI). However, the decision to perform CT for MHI largely depends on the physician. Data on severe head injuries is available in sources such as the Japan Neurotrauma Data Bank, but only a few data has been collected on MHI. A total of 1688 patients with MHI (Glasgow Coma Scale 14 and 15) treated at our hospital from June 2017 to May 2019 were reviewed. CT was performed in 1237 patients (73.28%), and intracranial hemorrhage was detected in 50 patients. Three patients deteriorated, and all were surgically treated. Statistical analysis of the presence or absence of acute intracranial hemorrhage and "risk factors for complications of intracranial lesions in MHI" showed significant differences in unclear or ambiguous accident history (p = 0.022), continued post-traumatic amnesia (p < 0.01), trauma above the clavicles including clinical signs of skull fracture (skull base or depressed skull fracture) (p = 0.012), age <60 years (p < 0.01), coagulation disorders (p < 0.01), and alcohol or drug intoxication (p < 0.01). The 453 patients who did not satisfy these risk factors included only one patient with intracranial hemorrhage, so the negative predictive value was 99.78%. This study shows that the "risk factors for complications of intracranial lesions in MHI" are effective criteria for excluding acute intracranial hemorrhage and CT should be actively considered for patients with the above factors that showed significant differences.</description><subject>acute intracranial lesions</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amnesia</subject><subject>Brain Concussion - diagnostic imaging</subject><subject>Brain injury</subject><subject>Child</subject><subject>Computed tomography</subject><subject>computed tomography (CT)</subject><subject>Craniocerebral Trauma - complications</subject><subject>Craniocerebral Trauma - diagnostic imaging</subject><subject>Female</subject><subject>Fractures</subject><subject>Glasgow Coma Scale</subject><subject>Head injuries</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Intoxication</subject><subject>Intracranial Hemorrhages - diagnostic imaging</subject><subject>Intracranial Hemorrhages - etiology</subject><subject>Japan</subject><subject>Male</subject><subject>Middle Aged</subject><subject>mild head injury</subject><subject>Neuroimaging</subject><subject>Original</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Skull</subject><subject>Statistical analysis</subject><subject>Tomography, X-Ray Computed</subject><subject>Trauma</subject><subject>Young Adult</subject><issn>0470-8105</issn><issn>1349-8029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNpVkU1v1DAQhiMEoqvSH8AFReKc4u-PEyoraFcq4kA5WxPb2XqVtYudReLf45A20MuM7HnnmdG8TfMWo0uCpfhwiKWLR3tJEKEdIlq-aDaYMt2p-njZbBCTqFMY8bPmopTQI0SYYlTJ181ZjVhzqTfN1TbFEpzPMIUU2zS0nzKE2G7v2t0R9iHu2-8TRAfZtUPK7dcwuvbGg2t38XDKwZc3zasBxuIvHvN58-PL57vtTXf77Xq3vbrtrNB06rzCFlMYBKGSa2clE0Ro55SkXHHeA2IgavZaqgE49kBJrxWVlPXEgafnzW7hugQH85DDEfJvkyCYvx8p7w3kKdjRG0wxOG0VFwQzBq73nDvNHXdIgXW2sj4urIdTf_TO-jhlGJ9Bn1diuDf79MtgTCiqK1fC-0dCTj9PvkzmkE451gOYKkAYI8FnFV5UNqdSsh_WERiZ2UVTXTTVRTO7aGYXa8-7_3dbO548q4LrRVCrwcKY4hii_zffOhz9KfuZyQxCgiFRE694JmvghFGNGZ9HbRfSoUyw9-uopzvOiwlmxBzWBdeqvYdsfKR_AFANxq0</recordid><startdate>20240615</startdate><enddate>20240615</enddate><creator>KUMAGAWA, Takahiro</creator><creator>OTAKI, Ryo</creator><creator>MAEDA, Takeshi</creator><creator>SHIJO, Katsunori</creator><creator>YOSHINO, Atsuo</creator><general>The Japan Neurosurgical Society</general><general>THE JAPAN NEUROSURGICAL SOCIETY</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20240615</creationdate><title>Consideration of Brain CT Imaging Standard for Mild Head Injuries</title><author>KUMAGAWA, Takahiro ; OTAKI, Ryo ; MAEDA, Takeshi ; SHIJO, Katsunori ; YOSHINO, Atsuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c693t-e81c13af623759dc746269dd8735855ba04a655be978fa51ea32b983734b2dae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>acute intracranial lesions</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Amnesia</topic><topic>Brain Concussion - diagnostic imaging</topic><topic>Brain injury</topic><topic>Child</topic><topic>Computed tomography</topic><topic>computed tomography (CT)</topic><topic>Craniocerebral Trauma - complications</topic><topic>Craniocerebral Trauma - diagnostic imaging</topic><topic>Female</topic><topic>Fractures</topic><topic>Glasgow Coma Scale</topic><topic>Head injuries</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Intoxication</topic><topic>Intracranial Hemorrhages - diagnostic imaging</topic><topic>Intracranial Hemorrhages - etiology</topic><topic>Japan</topic><topic>Male</topic><topic>Middle Aged</topic><topic>mild head injury</topic><topic>Neuroimaging</topic><topic>Original</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Skull</topic><topic>Statistical analysis</topic><topic>Tomography, X-Ray Computed</topic><topic>Trauma</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KUMAGAWA, Takahiro</creatorcontrib><creatorcontrib>OTAKI, Ryo</creatorcontrib><creatorcontrib>MAEDA, Takeshi</creatorcontrib><creatorcontrib>SHIJO, Katsunori</creatorcontrib><creatorcontrib>YOSHINO, Atsuo</creatorcontrib><creatorcontrib>Department of Neurological Surgery</creatorcontrib><creatorcontrib>Nihon University School of Medicine</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Neurologia Medico-Chirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KUMAGAWA, Takahiro</au><au>OTAKI, Ryo</au><au>MAEDA, Takeshi</au><au>SHIJO, Katsunori</au><au>YOSHINO, Atsuo</au><aucorp>Department of Neurological Surgery</aucorp><aucorp>Nihon University School of Medicine</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Consideration of Brain CT Imaging Standard for Mild Head Injuries</atitle><jtitle>Neurologia Medico-Chirurgica</jtitle><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><date>2024-06-15</date><risdate>2024</risdate><volume>64</volume><issue>6</issue><spage>247</spage><epage>252</epage><pages>247-252</pages><artnum>2023-0297</artnum><issn>0470-8105</issn><eissn>1349-8029</eissn><abstract>It has been reported that various clinical criteria indicate computed tomography (CT) examination for mild head injury (MHI). However, the decision to perform CT for MHI largely depends on the physician. Data on severe head injuries is available in sources such as the Japan Neurotrauma Data Bank, but only a few data has been collected on MHI. A total of 1688 patients with MHI (Glasgow Coma Scale 14 and 15) treated at our hospital from June 2017 to May 2019 were reviewed. CT was performed in 1237 patients (73.28%), and intracranial hemorrhage was detected in 50 patients. Three patients deteriorated, and all were surgically treated. Statistical analysis of the presence or absence of acute intracranial hemorrhage and "risk factors for complications of intracranial lesions in MHI" showed significant differences in unclear or ambiguous accident history (p = 0.022), continued post-traumatic amnesia (p < 0.01), trauma above the clavicles including clinical signs of skull fracture (skull base or depressed skull fracture) (p = 0.012), age <60 years (p < 0.01), coagulation disorders (p < 0.01), and alcohol or drug intoxication (p < 0.01). The 453 patients who did not satisfy these risk factors included only one patient with intracranial hemorrhage, so the negative predictive value was 99.78%. This study shows that the "risk factors for complications of intracranial lesions in MHI" are effective criteria for excluding acute intracranial hemorrhage and CT should be actively considered for patients with the above factors that showed significant differences.</abstract><cop>Japan</cop><pub>The Japan Neurosurgical Society</pub><pmid>38719579</pmid><doi>10.2176/jns-nmc.2023-0297</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | acute intracranial lesions Adolescent Adult Aged Aged, 80 and over Amnesia Brain Concussion - diagnostic imaging Brain injury Child Computed tomography computed tomography (CT) Craniocerebral Trauma - complications Craniocerebral Trauma - diagnostic imaging Female Fractures Glasgow Coma Scale Head injuries Hemorrhage Humans Intoxication Intracranial Hemorrhages - diagnostic imaging Intracranial Hemorrhages - etiology Japan Male Middle Aged mild head injury Neuroimaging Original Patients Retrospective Studies Risk Factors Skull Statistical analysis Tomography, X-Ray Computed Trauma Young Adult |
| title | Consideration of Brain CT Imaging Standard for Mild Head Injuries |
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