“Minor traumatic brain injury (MTBI) is defined by a history of disorientation, amnesia, or transient loss of consciousness in a patient who is conscious and talking. This correlates GCS score between 13 and 15.”*
“Most patients with minor brain injury make uneventful recoveries. Approximately 3% have unexpected deterioration, potentially resulting in severe neurologic dysfunction unless the decline in mental status is detected early.”*
| INDICATIONS FOR CT SCANNING IN MTBI FROM ATLS, TABLE 6.3* | |
| Head CT is required for patients with minor head injuries (i.e., witnessed loss of consciousness, definitive amnesia, or witnessed disorientation in a patient with GCS score of 13—15) and any one of the following factors: | |
High risk for neurosurgical intervention
|
Moderate risk for brain injury on CT
|
The table is adapted from The Canadian CT Head Rule for patients with minor head injury. Lancet 2001;357; 1294.
“Applying these [the above] parameters to patients with a score of 13, approximately 25% will have a CT finding indicative of trauma, and 1.3% will require neurosurgical intervention. Applying this to patients with a GCS score of 15, 10% will have CT findings indicative of trauma, and 0.5% require neurosurgical intervention”*
“If abnormalities are observed on the CT scan, or if the patient remains symptomatic or continues to have neurologic abnormalities, he or she should be admitted to the hospital , and a neurosurgeon should be consulted.”*
*Advanced Trauma Life Support Student Course Manual,9th ed, 2012, American College of Surgeons, p. 158.
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