Diagnosis and management of minor head injury : a regional multicenter approach in Italy.
Two series of patients admitted to the hospital after a minor head injury were collected in two different periods (1985 and 1989) in a regional hospital with a 24-hour computed tomography (CT) service, but without a neurosurgical unit.
In 1988, a regional protocol on the management of patients with minor head injury (based on the presence of skull fractures in adults and on clinical parameters in children) was adopted.
There was a 21% reduction in hospital admission in adults, and the number of skull x-ray films performed in children decreased significantly (p<0.01).
A more liberal use of CT examinations in asymptomatic patients with skull fractures produced an earlier identification of patients with extradural hematomas who were sent to neurosurgery before clinical deterioration with good results.
Detection of cerebral contusions was clinically less important.
Based on the availability of CT scanners in our area and on the results of our study, we have proposed new guidelines in management of minor head injury.
The CT scans are obtained in patients with a Glasgow Coma Scale score of 13 or less.
Skull x-ray films are obtained in patients older than 10 years with a Glasgow Coma Scale score of 14/15.
If a fracture is found, the patient is sent to the nearest regional center for CT examinations.
Children younger than 10 years are sent to a regional hospital with 24-hour CT availability for clinical observation or other indicated studies.
Mots-clés Pascal : Traumatisme, Crânioencéphalique, Diagnostic, Protocole thérapeutique, Recommandation, Italie, Europe, Etude multicentrique, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Système ostéoarticulaire pathologie, Crâne pathologie
Mots-clés Pascal anglais : Trauma, Craniocerebral, Diagnosis, Therapeutic protocol, Recommendation, Italy, Europe, Multicenter study, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Diseases of the osteoarticular system, Skull disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0018350
Code Inist : 002B16B. Création : 01/03/1996.