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Ann Emerg Med. 1994 Jun;23(6):1279-83.

The role of neuroimaging in the initial management of patients with minor head injury.

Author information

1
Department of Orthopaedic Surgery, University Hospital, Copenhagen County Hospital, Glostrup, Denmark.

Abstract

STUDY OBJECTIVE:

To determine whether omitting neuroimaging in the primary assessment of patients with minor head injuries in the emergency department is safe.

DESIGN:

Prospective cohort study.

SETTING:

University hospital, Copenhagen County Hospital, Glostrup, Denmark.

PARTICIPANTS:

The study group consisted of 2,204 patients presenting to the ED after sustaining minor head injuries. Only patients able to talk and walk were included.

MEASUREMENTS AND MAIN RESULTS:

The decision to admit was based exclusively on clinical guidelines in which the findings in the ED were of highest priority. Seven patients (0.3%) had a skull radiograph; computed tomography was not used in the primary evaluation. Four hundred thirty patients (19.5%) were admitted. After hospitalization, four patients developed intracranial complications. One required surgery, two required hyperventilation, and one was observed. Follow-up demonstrated that no patient with an intracranial complication had been missed.

CONCLUSION:

We found it safe to exclude neuroimaging in the primary assessment of patients with minor head injuries in the ED, and to rely instead on clinical criteria.

PMID:
8198301
DOI:
10.1016/s0196-0644(94)70352-3
[Indexed for MEDLINE]

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