Mild brain injury - Intracranial complications and indication criteria for CT imaging

Intracranial bleeding is revealed by CT scan in about 10% of patients who are examined after mild traumatic brain injury. The objective of this study is to analyze retrospectively the incidence of intracranial haemorrhage in patients admitted to our department with a diagnosis of concussion. A total of 274 patients were admitted to our department with such a diagnosis during the year 2009. CT examinations were requested in 188 cases. The indication criteria were age over 60 years, skull fracture, coagulopathy or dangerous mechanism of injury (e.g. traffic accident). Intracranial bleeding had occurred in 41 patients (21.8%) examined by CT scan even if their clinical status appeared good. Two of them had to be operated upon in the light of deterioration in their neurological findings. The purpose of this study is to warn against the danger intrinsic to these injuries, because even if the patient's clinical status appears good, they may have intracranial bleeding, which may, in turn - if rarely - require operation.