CT scans essential after posttraumatic loss of consciousness

dThe frequency of "talk and deteriorate" in the emergency department (ED), subsequent deterioration of patients with seemingly "mild" head injury at t he time of presentation, is summarized. Among the 1,073 patients with minor head injury treated in the last 5 years, five patients (0.5%) deteriorated in the ED. AII of the five patients had experienced transient loss of cons ciousness (LOC) before presentation. Deterioration had occurred during trea tment of trivial associated injuries in four-fifths of the cases. Computed tomography (CT) scans revealed four acute epidural hematomas and one cerebe llar contusion. Retrospectively immediate brain CT shortly after their arri val may have revealed the presence of traumatic intracranial hematomas befo re deterioration. Although routine use of CT scans in patients with mild he ad injury has been controversial, the authors conclude that CT scans should be taken if patients have experienced transient LOC to prevent or reduce t he occurrence of deteriolation in ED. Copyright (C) 2000 by W.B. Saunders C ompany.