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The decision as to whether to perform a CT examination of the brain in patients with a Glasgow coma score of 15 after injury is often difficult, given the limited CT scanning facilities available in state hospitals. A retrospective evaluation of 100 consecutive head-injury patients presenting with a Glasgow coma score of 15 at Tygerberg Hospital was therefore carried out. In a surprisingly high number of patients (50%) abnormal findings due to the injury were detected. Analysis of the clinical history parameters did not demonstrate a significant association with abnormal CT findings. It is therefore concluded that brain CT examination in patients with a Glasgow coma score of 15 is justified and that the Glasgow coma scale is a poor predictor of intracranial injury.

The patient with head injury and a Glasgow coma score of 15: Is a brain CT examination indicated?