Cranial computed tomography in diagnosis and management of acute head trauma

TLDR

Hemorrhagic contusions are the most common lesion in acute head trauma and can cause focal neurological deficits, while general cerebral swelling—especially common in children—requires prompt medical management for full recovery. In a review of 286 patients, computed tomography identified hemorrhagic contusions, intracerebral and extracerebral hematomas, cerebral swelling, and white‑matter shearing, and its use lowered mortality for hematomas and reduced arteriography, surgical intervention, and skull radiography by 84 %, 58 %, and 24 % respectively.

Abstract

Review of the computed tomographic findings in 286 patients with acute craniocerebral trauma revealed several types of lesions: hemorrhagic contusion, intracerebral and extracerebral hematomas, general and focal cerebral swelling, and shearing injury of the cerebral white matter. Hemorrhagic contusions are the most frequent lesion and may result in focal neurologic deficits. General cerebral swelling occurs frequently in children and necessitates prompt medical management for complete recovery. Mortality rates for intracerebral, subdural, and epidural hematomas were lower for this series than for series that preceded computed tomography. Because of the availability of computed tomography, there was an 84% reduction in arteriography, 58% reduction in surgical intervention, and a 24% reduction in skull radiography.