REPEATED COMPUTERIZED-TOMOGRAPHY DURING A CUTE-PHASE OF HEAD-INJURIES

Because of methodological reasons, within the first day after a head t rauma, CT scan often does not demonstrate all the pathological consequ ences of brain injury. Additionally, secondary sequelae are frequent e vents. In our series of 129 patients the findings on subsequent CT sca ns done during the posttraumatic course were worse compared to the ini tial CT in 45% of patients. This deterioration on the CT scan was seen irrespective of the initial GCS score and the initial diagnosis of ci rcumscribed or diffuse injury. The event observed most often was bleed ing into a preexisting contusion or even bleeding into a region which had looked normal on the first CT scan. In the vast majority of cases, this happened within the first 2 weeks after the initial trauma. We c onclude that an initially pathological CT should be repeated early in the posttraumatic period even in patients with mild to moderate head i njury. In particular, we recommend that patients having sustained diff use brain injuries should be transferred to neurotraumatology units fo r specialised management, even when there may not be immediately obvio us indications for surgical intervention.