Utility of routine serial computed tomography for blunt intracranial injury

Background: To determine the utility of routine serial head computed tomogr aphy (H-CT) for predicting need for invasive neurosurgical intervention in patients with blunt intracranial injuries (BICI). Methods: Patients treated at a Level I trauma center with BICI over a 4-yea r period were reviewed. Results: Of the 4,273 blunt trauma patients evaluated, 9.7% (415/4,273) wer e diagnosed as having BICI. Invasive intervention (craniotomy, ICP monitori ng, ventriculostomy, or angiogram) was performed in 41.2% (171/415) of pati ents with BICI Of these, 94.7% (162/171) had the procedure performed as a r esult of the initial H-CT. The remaining 5.3% (9/171) had the intervention performed as a result of a subsequent H-CT. Serial H-CT documented worsenin g of BICI in 32.3% (64/198) of the patients, but only those who had signifi cant corresponding clinical deterioration had an procedure as, a result. Conclusion: In patients with an unchanged or normal neurologic exam, a rout ine serial H-CT did not influence subsequent invasive neurosurgical interve ntion.