Turkish Neurosurgery 2011 , Vol 21 , Num 4
The Traumatic Brain Injury: Diagnosis and Management at Emergency Department by General Surgeon. A Retrospective Critical Analysis on the Use of the Ct Head Scan
John SIASIOS1, Soultana FOUTZITZI2, Savas DEFTEREOS2, Michael KARANIKAS1, Theodosıos BIRBILIS3
1University Hospital of Alexandroupolis, First Department of Surgery, Alexandroupoli, Greece
2University Hospital of Alexandroupolis, Department of Radiology, Alexandroupoli, Greece
3University Hospital of Alexandroupolis, Department of Neurosurgery, Alexandroupoli, Greece
DOI : 10.5137/1019-5149.JTN .3749-10.1 AIM: In recent decades, considerable progress has been made in diagnosis and management of cranial trauma patients. Computed Tomography has resulted in a revolution in head injury diagnosis, making it possible to detect cases suitable for surgical treatment in a rapid, non-invasive manner. We present our experience in treating patients with head injuries at Emergency Department by describing the process and the criteria under which any diagnostic test is performed focusing in CT head scan.

MATERIAL and METHODS: Between 2007-2009 we studied 1356 adult patients (725 male and 631 female) who came at the emergency department claiming head injury. The factors registered were the mechanism of injury, the neurological evaluation, the Glasgow Coma Scale (GCS), the specialty of the doctor who made the first evaluation, and finally in which cases and with which criteria the CT scan was performed.

RESULTS: Only a disproportionate small number of the patients who arrive at the emergency room claiming head injury require neurosurgical intervention (4.8% in our study). The majority of the CT scans who are performed as emergency procedure have no pathological findings (53.4%).

CONCLUSION: The general surgeon with the appropriate education is able to evaluate the patients with head injury. Keywords : Traumatic brain injury, Glasgow coma scale, Emergency department, Intensive care unit, CT scan

Corresponding author : John Sıasıos, siasiosj@yahoo.gr