Head Injury Research Paper

Abstract:
CT scan is considerably relied upon in emergency departments in the management of trauma victims especially in cases of head injuries. Although, the detection of un-displaced fracture on CT scan head without significant intracranial findings may be insignificant for a clinician; nevertheless such cases are of paramount importance for medico-legal purposes in ascertaining the nature, manner and mechanism of injury that always help in the aid of justice. The study was conducted with objective of knowing the sensitivity and specificity of ante-mortem CT scan findings indicating the presence or absence of fractures of skull. Findings were confirmed during postmortem examination of the subjects who had expired during management but without …show more content…
In India, nearly 2 million persons are injured with about 1 million deaths every year due to head injury. 60% of the total cases are mainly due to road traffic accidents, followed by falls and violence.1 Computerized tomography (CT) scan is the primary screening modality of investigations in the head trauma victims.2,3 The merits of CT for assessment of head injury is its sensitivity for demonstrating bone injuries apart from mass effect, ventricular size and configuration and acute hemorrhage.4 Since the inception of CT in 1971 by Sir Godfrey Hounsfield, there has been vast advancements in CT imaging from time-intensive single-section scanning to the present multidetector row CT, which enables acquisition of isotropic datasets with a voxel dimension of ≤0.6mm.5 The Emergency departments relies upon the CT scans to have rapid, accurate injury assessment.6 In clinical settings the diagnosis of isolated, undisplaced fracture is not important as long as there are no clinical symptoms or complications; but it is having a paramount importance in all medico-legal …show more content…
A linear fracture that comes in the plane of CT slice may not be visualized. CT scan may have an upper hand to radiography for base of skull fractures, provided the plane of slice involves the fracture line.3,8,9 Linear fracture of the calvarium and cranial base are difficult to be identified by CT unless depressed or separated.10 Depressed fractures sometimes may require coronal reconstructions for delineation.3 High spatial resolution CT scan with a thickness of 3 mm or less is required to delineate a fracture in suspected basilar skull fracture.3 Thin sections of axial and direct coronal imaging with bone algorithm reconstruction are recommended for delineation of temporal bone fractures. Imaging in coronal plane can be difficult in trauma patients especially if intubated or having suspected cervical spine injury. In that case, thinner section axial imaging can be performed with MDCT (Multi-detector CT) and coronal reformats can be made out for interpretation.9 Moreover the patients of head injury are uncooperative many a times and sedation is not recommended as per treatment protocol of such cases. If there is sudden movement of patient at the time of imaging in that particular plane where fracture lies, the chances of fracture to be missed are on higher side.
On comparison to our results, in one of the earlier studies the overall sensitivity of CT for skull fractures was 25.7% where images were

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