What a lovely day - two of our CHIP papers were published today!
The first is our validation study of clinical guidelines for the use of CT in minor head injury, published in Radiology. Disappointingly, not one of the guidelines we looked at was obviously better than any of the others, all showing a similar balance between sensitivity for neurocranial CT findings and the proportion of patients that needed to be scanned. In other words, if you want all patients with a neurocranial complication to be identified, you will need to scan all minor head injury patients. If the aim is to reduce the number of CT scans for this indication, you are going to miss some patients with a neurocranial complication.
The second is our study showing that patients without a history of loss of consciousness are also at risk of neurocranial complications after minor head injury, published in the Journal of Neurology, Neurosurgery and Psychiatry. The traditional definition of minor head injury requires a history of loss of consciousness to be present, while the risk of neurocranial complications after head injury without loss of consciousness is generally assumed to be minimal. Loss of consciousness is therefore often used as a means of triaging patients in emergency departments. Just like everything else in life, things just aren’t that simple.