The standard imaging methods to assess traumatic brain injury are taking a beating this month. After one study brought the use of CT (computed tomography) scans into question entirely when compared to MRI scans, another study has destabilized another care standard, as News Medical reports.
Normally, trauma centers schedule a follow-up CT scan within 24 hours of the initial scan standardly given when diagnosing patients, but Canadian researchers say the second scan is unnecessary. The second CT scan is intended to rule out secondary changes that might need intervention, even when patients seem stable or show signs of improvement.
But in the study, published in Neurology, the researchers from McMaster University in Ontario found that reimaging led to intervention in only 2 out of 445 patients not showing signs of neurologic deterioration.
The head of the team, Saleh Almenawer said, “considering that this practice is neither risk nor cost free, evidence-based rules should be implemented. […] Furthermore, we found that the simple yet important neurological examination is the predictive factor in changing the management and guiding the need for repeat imaging after mild head injury.”
The study only looked at patients with mild brain injury, and may not be consistent with those who have more severe brain injuries. Almenawer explained, “considering our hypothesis that the neurological examination is a better and risk-free indicator of intervention, we excluded the population of patients with moderate and severe head injuries because monitoring these groups is more difficult and less sensitive.”