The requisitions of computed tomographic scans of brains and the findings in the patients at Division of Accident and Emergency, Sappasitthiprasong Hospital

Abstract

          The computed tomographic (CT) scans of brains have been increased continually each year at Sappasitthiprasong Hospital. In 2006, 80% of them were from Accident-Emergency Division with the patients’ conditions of some clinical symptoms and Glasgow Coma Scale (GCS) score, of 15 were the most. The retrospective study was performed by reviewing the medical cards and CT scan brain findings of patients presented to Division of Accident-Emergency during August to October 2006. The demographic data, GCS score and clinical symptoms or indications were collected to observe the prevalence of negative and positive CT findings in order to determine the indications that favorably correlated with positive CT findings in acute traumatic head injuries with GCS 15. There were totally 454 patients included; 43.08± 13.30 years of average age, male 69.16%. The numbers of positive findings were more than of negative ones in non- traumatic cases and traumatic cases with GCS less than 14. But of the 243 traumatic cases, only 84 had positive CT scan brain findings, of which 14 cases or 10.7% were with GCS score of 15. In this group the indications that significantly constituted positive CT findings were headache, sign of basal skull fracture, skull fracture, nausea vomiting, drowsiness and amnesia, respectively (P< 0.01, LLR= 9.63, 8.54, 6.27, 5.42, 5.29 and 4.84). The indications should be validated at settings before uses.