Nowadays physicians in emergency departments refer multi trauma or head trauma patients routinely first to spiral brain CT without considering exact neurological exam and reminding red flags. Can anyone mention global criteria for brain CT in head trauma cases?
It depends on physician's critieria and equipment availability.
IMHO if you have access to the equipment I would always ask for a CT image, as you can get important information not accessible by other means.
Dear Ramin,
As, said by Mario it depends on the Physician. Further the sign and symptoms which the patient show.
Below I am attaching a link of an article, when Imaging is used at what time and condition.
Article Imaging after head trauma: Why, when and which
https://academic.oup.com/neurosurgery/article/80/1/6/2585042
No. - Maybe this link will help you for clinical decisions: https://www.mdcalc.com/canadian-ct-head-injury-trauma-rule
Not always.
Some patients can be cleared clinically, despite in an era of defensive medicine, doctors rely more on imaging for safety.
However, one old concept but still applied in many centers is "delayed intracerebral haemorrhage", where an immediate CT can miss a bleed which can develop later.
Some centers delay for CT for 6 hours unless signs develop (e.g. Seizure, dropping GCS, etc). However, I am not sure if this is still applicable with the currently available hyper-sensitive thin slice CT. In fact, some very small lesions with no clinical significance can be detected!
Hope this is of benefit!
I recomand the EEG Mapping Investigation (especially when made in "Source Derivation"). This is functional. We found important proves of contusion, remaining even in the late, so called "Posttraumatic Syndrome".
Psatta DM, Matei M, Alexianu D.: Cerebral damage revealed by EEG Mapping long term after closed head injuries. Rom J Neurol, 1999, 37, 3-9.
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