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Utility of Repeat Head CT in Patients with Blunt Traumatic Brain Injury Presenting with Small Isolated Falcine or Tentorial Subdural Hematomas.
Devulapalli, K K; Talbott, J F; Narvid, J; Gean, A; Rehani, B; Manley, G; Uzelac, A; Yuh, E; Huang, M C.
Afiliación
  • Devulapalli KK; From the Department of Radiology and Biomedical Imaging (K.K.D., J.F.T., J.N., A.G., B.R., A.U., E.Y.), University of California, San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California.
  • Talbott JF; From the Department of Radiology and Biomedical Imaging (K.K.D., J.F.T., J.N., A.G., B.R., A.U., E.Y.), University of California, San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California Jason.talbott@ucsf.edu.
  • Narvid J; Department of Neurological Surgery (J.F.T., G.M., E.Y., M.C.H.), Brain and Spinal Injury Center, San Francisco, California.
  • Gean A; From the Department of Radiology and Biomedical Imaging (K.K.D., J.F.T., J.N., A.G., B.R., A.U., E.Y.), University of California, San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California.
  • Rehani B; From the Department of Radiology and Biomedical Imaging (K.K.D., J.F.T., J.N., A.G., B.R., A.U., E.Y.), University of California, San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California.
  • Manley G; From the Department of Radiology and Biomedical Imaging (K.K.D., J.F.T., J.N., A.G., B.R., A.U., E.Y.), University of California, San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California.
  • Uzelac A; Department of Neurological Surgery (G.M., M.C.H.), Zuckerberg San Francisco General Hospital, San Francisco, California.
  • Yuh E; Department of Neurological Surgery (J.F.T., G.M., E.Y., M.C.H.), Brain and Spinal Injury Center, San Francisco, California.
  • Huang MC; From the Department of Radiology and Biomedical Imaging (K.K.D., J.F.T., J.N., A.G., B.R., A.U., E.Y.), University of California, San Francisco and Zuckerberg San Francisco General Hospital, San Francisco, California.
AJNR Am J Neuroradiol ; 39(4): 654-657, 2018 Apr.
Article en En | MEDLINE | ID: mdl-29496726
BACKGROUND AND PURPOSE: In blunt traumatic brain injury with isolated falcotentorial subdural hematoma not amenable to neurosurgical intervention, the routinely performed, nonvalidated practice of serial head CT scans frequently necessitates increased hospital resources and exposure to ionizing radiation. The study goal was to evaluate clinical and imaging features of isolated falcotentorial subdural hematoma at presentation and short-term follow-up. MATERIALS AND METHODS: We performed a retrospective analysis of patients presenting to a level 1 trauma center from January 2013 to March 2015 undergoing initial and short-term follow-up CT with initial findings positive for isolated subdural hematoma along the falx and/or tentorium. Patients with penetrating trauma, other sites of intracranial hemorrhage, or depressed skull fractures were excluded. Patient sex, age, Glasgow Coma Scale score, and anticoagulation history were obtained through review of the electronic medical records. RESULTS: Eighty patients met the inclusion criteria (53 males; 27 females; median age, 61 years). Of subdural hematomas, 57.1% were falcine, 33.8% were tentorial, and 9.1% were mixed. The mean initial Glasgow Coma Scale score was 14.2 (range, 6-15). Isolated falcotentorial subdural hematomas were small (mean, 2.8 mm; range, 1-8 mm) without mass effect and significant change on follow-up CT (mean, 2.7 mm; range, 0-8 mm; P = .06), with an average follow-up time of 10.3 hours (range, 3.9-192 hours). All repeat CTs demonstrated no change or decreased size of the initial subdural hematoma. No new intracranial hemorrhages were seen on follow-up CT. CONCLUSIONS: Isolated falcotentorial subdural hematomas in blunt traumatic brain injury average 2.8 mm in thickness and do not increase in size on short-term follow-up CT. Present data suggest that repeat CT in patients with mild traumatic brain injury with isolated falcotentorial subdural hematoma may not be necessary.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tomografía Computarizada por Rayos X / Lesiones Traumáticas del Encéfalo / Hematoma Subdural Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: AJNR Am J Neuroradiol Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tomografía Computarizada por Rayos X / Lesiones Traumáticas del Encéfalo / Hematoma Subdural Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: AJNR Am J Neuroradiol Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos