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Title: Isolated mild head injuries In patients attending the emergency departament : value of imaging diagnostic, clinical symtoms and selected coexisting risk factors

Abstract:

Isolated cranio-cerebral injuries occur in 200-300 individuals per 100 000 inhabitants a year. In 85% of cases are mild head injury which are defined as an admission Glasgow Coma Scale (GCS) score of 13 to 15 points. The aim of this study was to analyze the results of CT scans of head and radiological images (X-ray) of the skull, post-traumatic neurological disorders such as anisocoria, otorrhoea, amnesia, vomiting, dizziness and selected risk factors in patients with isolated mild head injuries. The clinical material consisted of 293 patients attending the University Hospital Emergency Department in Krakow with isolated mild head injuries who were treated in the period from 01.01.2004 until 31.12.2006. The study was a prospective analysis of this group of patients. After a physical examination all patients were qualified for the study group on the assessment GCS (Glasgow Coma Scale). Statistical analysis was performed in STATISTICA package. Descriptive statistics included tables containing the number of patients (n), and their percentage (%). Relevance of diagnostic radiology for CT was assessed by calculating the sensitivity and specificity of the test, and a coefficient of Cohen's Kappa. The significance of differences between the cases of interest in the various subgroups of patients verified the test fraction, and the compliance of diagnostic test characteristics and the dependence of test verified c2 and c2 test with Yates' correction or Fisher's exact test. To identify the risk factors for changes in the CT (skull fracture and intracranial lesions) using the method of multidimensional statistical analysis of prostate inclusion of independent variables into a logistic regression model. The CT-traumatic intracranial lesions were found in 21(7.17%) patients, of whom 13 patients (4.44%) patients had cerebral contusion, 5(1.71%) subdural or epidural hematoma, 3 patients (1.02% ) parenchymal hematoma. Post-traumatic skull fractures in CT was found in 32(34.41%) patients. Only in 20 of these patients they were found on X-ray study (62.5%). At the same time there was not found any correlation between the occurrence of some neurological symptoms and the presence of intracranial posttraumatic lesions. Computed tomography proved to be the decisive test in this analysis, and therefore preferred to be performed on every patient with mild head injury. At the same time it was showed that the plain skull radiograph is of little value In the initial assessment of mild head injured patients and it does not have a major impact on the entire diagnostic and therapeutic process and at the same time characterized by much lower sensitivity and specificity of CT .

Level of degree:

2 - studia doktoranckie

Degree discipline:

traumatologia

Degree grantor:

Wydział Lekarski

Promoter:

Waldemar Hładki

Date issued:

2010

Format:

application/msword

Identifier:

oai:dl.cm-uj.krakow.pl:813

Call number:

ZB-113524

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Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Oct 9, 2019

In our library since:

Nov 21, 2012

Number of object content hits:

1

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/813

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ZB-113524 Oct 9, 2019
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