Abstract Details

Title The Spectrum of Head CT Findings in Mild TBI and Their Symptomatic Predictors

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P06 - (-)

Poster/Presentation
Number 240

Objective

Background BACKGROUND: Pathoanatomic classification systems for TBI are primarily CT based. The authors have previously demonstrated that upto 25% of patients with a GCS of 15, the mildest of mild TBIs- have gross CT abnormalities. The current study aims to characterize these findings.

Design/Methods DESIGN/METHODS: This was a prospective IRB approved cohort study (n=1245). Patients were enrolled from the Emergency Department (ED) if they sustained a head injury within the prior 24 hours. Patients underwent standard brain CT imaging while in the emergency department. In addition, neurocognitive, and visuomotor testing was performed. Demographic questionnaires systematically assessed for injury characteristics, mechanism, and severity. Data were input into RedCap, and JMP 9,0 for the mac were sued to perform statistical analyses.

Results RESULTS: Abnormal Head CT findings in GCS 15 Extracalvarial Swelling 91 (7%) Fracture of Skull1 58 (5%) Fracture of Maxillo-facial bones 50 (4%) Fracture of Nasal Bone 34 (3%) Calvarial Fracture through Carotid canal or foramen magnum 0 Subfalcine Herniation 11 (1%) Downward transtentorial Herniation 4 (0.02%) Uncal Heniation 4 (0.02%) Tonsillar herniation 20 (2%) Epidural Hematoma 82 (7%) Subdural Hematoma 79 (6%) Subarachnoid Hemorrhage 56 (5%) Intraventricular Hemorrhage 3 (0.25%) Parenchymal or Hemorrhagic contusion 51 (5%) Diffuse Axonal Injury 5 (0.5%) In a multivariate model taking into account presenting injury symptoms, age, mechanism and antiplatelet use, the following were significantly associated with having an abnormal head CT: older age (p<0.0001); alteration in consciousness (p=.0013); post traumatic amnesia (p=0.0013).

Conclusions CONCLUSIONS: The presence of AOC or PTA appears to be significantly associated with having an abnormal head CT after acute TBI. These data may aid in risk stratifying patients for acute neuroimaging.

Authors/Disclosures
Latha Ganti, MD, MS, MBA, FACEP PRESENTER	Dr. Ganti has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Ganti has received publishing royalties from a publication relating to health care.
Aakash N. Bodhit, MD (Dignity Health-St. Mary's Health Center)	No disclosure on file
	No disclosure on file
Yasamin Daneshvar, BA	No disclosure on file
	No disclosure on file
Per Soelberg Sorensen	No disclosure on file
Bayard D. Miller, MD	No disclosure on file

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