Does Rinse and Repeat Apply To CT Scans?

Neurological exams can determine the need for repeat CT scan in mild head injury patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Patients want the best care, especially when it comes to potential brain injury. Is more scanning always the best option or is it best to wait for evidence that imaging is needed?

A recent study looked at the need for repeated scans in patients with mild head trauma. The study showed that additional CT scans after mild head injury were unnecessary when there was no unexpected change or neurological decline in the patient’s condition.

"Discuss the need for CT scans with your doctor"

Saleh Almenawer, MD, of the Department of Surgery at McMaster University and colleagues reviewed fifteen previous studies of CT imaging and the records of 445 mild head injury patients that showed bleeding within the brain on their initial CT scans.

Mild head trauma may be caused by a blow or jolt to the head. It is possible for the injury to cause changes to the way your brain normally works. These changes are usually temporary.

The patients were divided into two groups. One group had intervention based on repeated CT results exclusively.

The other group had intervention based on neurological examination changes. These patients immediately received a CT scan if the results of the exam indicated one was needed.

Intervention was considered any change in medical treatment or management such as drugs or surgery to relieve pressure in the brain.

The current standard of care in many places is to obtain a second CT scan within 24 hours to make sure that there is no further bleeding in the brain regardless of the patient’s neurological condition.

The results of the study showed that significantly more interventions occurred because of neurological intervention than CT scan. The neurological examination group had a 2.7 percent rate of intervention and the imaging group had a 0.6 percent rate of intervention.

These results suggested that neurological examination followed by imaging was a more effective tool than imaging alone.

The authors explain that repeat CT scan without evidence that it is needed is unnecessary, costly and may have long-term radiation side effects.

The authors warn that the results of this study apply only to mild head injury. More severe injuries are likely to need more aggressive treatment.

The study was published in Neurosurgery, the official journal of the Congress of Neurological Surgeons.

The authors report no conflicts of interest.

Reviewed by: 
Review Date: 
January 24, 2013
Last Updated:
January 26, 2013