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Revista Uruguaya de Medicina Interna

Print version ISSN 2393-6797On-line version ISSN 2393-6797


MOREIRA MILANESI, Emilia et al. CT scan of the skull in mild head trauma, are these necessary in all cases?. Rev. Urug. Med. Int. [online]. 2021, vol.6, n.1, pp.34-44.  Epub Mar 01, 2021. ISSN 2393-6797.


The systematic performance of skull tomography in mild brain trauma is controversial, corresponding to 70-90% of cases. Up to 10% of these traumas will present injuries and 1.4% will require neurosurgery. The objective of the study is to determine the number of pathological scans in mild head injury and to identify predictive factors for injury.

Materials and methods:

Observational, prospective, analytical study. Consultations for mild brain injury were identified between July 30, 2018 and August 15, 2019. The presence of risk factors for injury was assessed as the Glasgow coma scale at admission and at 2 hours, trauma kinematics, suspicion of skull base and vault fracture, headache, vomiting, people over 65 years of age, loss of consciousness, amnesia of the episode, anticoagulation or antiplatelet therapy and alcohol or drug use. The cases with pathological tomography and the need for neurosurgery were consigned.


1,319 patients were included, 9% of pathological studies and 1.2% required neurosurgery. The high kinematics of trauma were significant as risk factors (p 0.02); Glasgow coma scale at 2 hours (p 0.014); suspicion of fracture of the vault (p 0.003) and skull base (p 0.000); vomiting on more than two occasions (p 0.000); headache (p 0.01) and episode amnesia (p 0.012).


The identification of predictive factors of injury helps to optimize the use of tomography time by eliminating unnecessary studies and prioritizing potentially pathological ones.

Keywords : Traumatic brain injuries; risk factor's; tomography, neurosurgery.

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