The traumatic brain injury: diagnosis and management at emergency department by general surgeon. A retrospective critical analysis on the use of the CT head scan.

AIM In recent decades, considerable progress has been made in diagnosis and management of cranial trauma patients. Computed Tomography has resulted in a revolution in head injury diagnosis, making it possible to detect cases suitable for surgical treatment in a rapid, non-invasive manner. We present our experience in treating patients with head injuries at Emergency Department by describing the process and the criteria under which any diagnostic test is performed focusing in CT head scan. MATERIAL AND METHODS Between 2007-2009 we studied 1356 adult patients (725 male and 631 female) who came at the emergency department claiming head injury. The factors registered were the mechanism of injury, the neurological evaluation, the Glasgow Coma Scale (GCS), the specialty of the doctor who made the first evaluation, and finally in which cases and with which criteria the CT scan was performed. RESULTS Only a disproportionate small number of the patients who arrive at the emergency room claiming head injury require neurosurgical intervention (4.8% in our study). The majority of the CT scans who are performed as emergency procedure have no pathological findings (53.4%). CONCLUSION The general surgeon with the appropriate education is able to evaluate the patients with head injury.