Open AccessAcute Bacterial Meningitis: A Systemic Review of Diagnosis and Treatment
Author(s) -
Paula Bryzgalov
Publication year - 2017
Publication title -
journal of neuroscience and neurological surgery
Language(s) - English
Resource type - Journals
ISSN - 2578-8868
DOI - 10.31579/2578-8868/027
Subject(s) - medicine , glasgow coma scale , trauma center , emergency department , head trauma , traumatic brain injury , injury severity score , head injury , emergency medicine , population , incidence (geometry) , level of consciousness , surgery , anesthesia , retrospective cohort study , poison control , injury prevention , physics , environmental health , psychiatry , optics
During 1987 and 1988, the trauma service at Hahnemann University Hospital, a level I trauma center, evaluated 1,875 consecutive patients. Four hundred ninety-seven consecutive computed tomographic (CT) scans were performed to evaluate intracranial trauma in the emergency department. These patients' records were reviewed to determine the adequacy of loss of consciousness, amnesia, Glasgow Coma Scale (GCS) score, and mechanism of injury in predicting intracranial findings. In 302 patients with a GCS score of 13 or greater, 55 (18%) CT scans showed abnormal findings. Eleven (4%) of these patients required neurosurgical intervention. Furthermore, patients with normal CT scans required no interventions for head trauma. Mechanism of injury directly influenced the incidence of neurosurgical intervention. Current bedside methods to evaluate patients for possible intracranial injury in our trauma patient population are inadequate. Emergency department CT scans should be performed on all patients referred to the trauma service with previously classified mild- or low-risk criteria for intracranial trauma, regardless of GCS score.