Efficacy of Repeat Head CT-Scan in Patients with Traumatic Brain Injury and Subdural Hematomas

Abstract

Objective: To assess the radiographic and clinical features of isolated tentorial and falcine subdural hemorrhages. Study Design: A retrospective cross-sectional review. Settings: A single large tertiary care hospital. Duration: Two years from June 2017 to June 2019. Methods: A retrospective cross-sectional review was conducted where we included all the patients above 18 years of age whose initial presentations had evidence of falcine and tentorial SDH due to traumatic brain injury. Patients with other sites of hemorrhage at presentation, contusions, neoplasia and depressed skull fractures were excluded from our study population. Patients with other causes of injury other than TBI and patients who had not had a repeat CT scan done within 7 days of injury were also excluded from our study. Results: The final study population was n= 102 patients. The mean age of the patients was 34.5 +/- 15.45 years, where n= 68 (66.66%) patients were male and n= 34 (33.33%) patients were female. The mean GCS score in our study population was 14.2 and the mean GCS score at discharge was 15. None of the patients in our study population suffered from an expansion of the SDH having a p value of 0.17. In patients having mild TBI there were no significant differences (p value of 0.12). For those patients having a GCS score of less than 13 there was no statistically significant difference in SDH size at initial presentation as compared to the size at follow up CT scan. Conclusion: We found that patients having isolated falcine and tentorial SDH do not require a routine repeat CT scan in the absence of any signs and symptoms of deterioration.