Examination of Pathological Findings in Brain CT Scan of Fully Conscious Patients with Mild Head Trauma; a Cross-sectional Study

Computed tomography (CT) scan is a valuable tool for diagnosis of abnormalities in brain or spinal cord as it has a high resolution in these tissues. Considering the importance of this subject, the researchers have aimed to evaluate the frequency of unnecessary CT scans performed for trauma patients in order to prevent unnecessary use of this diagnostic modality to avoid imposing probable side effects and financial burden on both the patient and the hospital.

In this cross-sectional study, through simple random sampling, participants were selected from fully conscious (Glasgow Coma Scale (GCS)=15) patients who presented to the emergency department with head trauma and underwent brain CT scan. The reasons for ordering a brain CT scan were recorded through an interview with the in-charge physician at the time of ordering this procedure, and clinical signs and demographic characteristics of the patients were also recorded using a questionnaire.

121 (81.8%) of the patients had normal CT scan, and skull fracture and hematoma were the most frequent complications found after trauma. The results also showed that in 90 (60.8%) cases, CT scan was ordered for documentation and legal purposes, and for 22 (14.9%) cases it was ordered because the patient had insisted and it was not deemed necessary by the in-charge physician, and only 26 (17.6%) were requested by the senior physician, which indicates that CT scans are not always necessary.

According to the results of this study, 18.2% of the CT scans performed on patients with mild head trauma showed at least 1 pathologic finding. Skull fracture and formation of intracranial hematoma were the most common pathologic findings in the CT scans of patients following mild head trauma. Due to the high frequency of normal CT scan results, in order to reduce the amount of radiation in patients and decrease the number of unnecessary CT scans, it is suggested to plan more strict criteria for ordering CT scans.