• A Chao, J Pearl, P Perdue, D Wang, A Bridgeman, S Kennedy, G Ling, and P Rhee.
• Department of Surgery, National Naval Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.
• J Trauma. 2001 Nov 1;51(5):870-5; discussion 875-6.

BackgroundTo determine the utility of routine serial head computed tomography (H-CT) for predicting need for invasive neurosurgical intervention in patients with blunt intracranial injuries (BICI).MethodsPatients treated at a Level I trauma center with BICI over a 4-year period were reviewed.ResultsOf the 4,273 blunt trauma patients evaluated, 9.7% (415/4,273) were diagnosed as having BICI. Invasive intervention (craniotomy, ICP monitoring, ventriculostomy, or angiogram) was performed in 41.2% (171/415) of patients with BICI. Of these, 94.7% (162/171) had the procedure performed as a result of the initial H-CT. The remaining 5.3% (9/171) had the intervention performed as a result of a subsequent H-CT. Serial H-CT documented worsening of BICI in 32.3% (64/198) of the patients, but only those who had significant corresponding clinical deterioration had an invasive procedure as a result.ConclusionIn patients with an unchanged or normal neurologic exam, a routine serial H-CT did not influence subsequent invasive neurosurgical intervention.

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