Faculty Collaboration Database

Is CT Angiography of the Head Useful in the Management of Traumatic Brain Injury? J Am Coll Surg 2015 Jun;220(6):1027-31

Date

04/16/2015

Pubmed ID

25872690

DOI

10.1016/j.jamcollsurg.2015.03.002

Scopus ID

2-s2.0-84929837236 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

BACKGROUND: Computed tomography angiography (CTA) has been increasingly used in traumatic brain injury (TBI) patients to uncover vascular lesions that might have preceded the trauma and caused the bleed. This study aims to evaluate the usefulness of head CTA in the initial care of blunt TBI patients.

STUDY DESIGN: We conducted a retrospective case-control analysis of adult TBI patients, admitted to our Level I trauma center from January 1, 2012 to December 31, 2012. The patients were grouped as those with and without a CTA of the head. The primary outcomes included a change in management after the findings of head CTA and secondary outcomes included rate of admission to the ICU, ICU length of stay, hospital length of stay, discharge disposition, and mortality.

RESULTS: Six hundred adult patients had blunt TBI and underwent head CT as a part of their evaluation. Of these 600 patients, 132 (22%) underwent head CTA in addition to CT. Only one patient had altered management after the CTA results; the patient had a diagnostic angiogram that was negative. Ninety-eight patients did not have any additional findings on CTA. Of the remaining 33 patients with additional CTA findings, 12 had incidental vascular malformations, which showed no acute pathology and were not related to the injury. In the matched comparisons, patients with CTA had a longer hospital stay, higher rate of ICU admission, and longer ICU stay. There was no significant difference in mortality and discharge disposition between the 2 groups.

CONCLUSIONS: Head CTA is commonly used after blunt TBI but does not alter management and should be abandoned in the absence of clear indications.

Author List

Naraghi L, Larentzakis A, Chang Y, Duhaime AC, Kaafarani H, Yeh DD, King DR, de Moya MA, Velmahos GC

Author

Marc Anthony De Moya MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Angiography
Brain Injuries
Female
Humans
Intracranial Hemorrhages
Male
Matched-Pair Analysis
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed
Wounds, Nonpenetrating