Monitoring
Non-contrast head computed tomography (CT) is usually appropriate for the short-term follow-up imaging of patients with acute head trauma who have unchanged neurological examination and positive finding(s) on initial imaging such as subdural haematoma (SDH).[48] Magnetic resonance imaging may be indicated as a follow-up study when there are persistent neurological deficits that remain unexplained after the head CT.[48] Routine follow-up scans in patients with a Glasgow Coma Scale score of 13 to 15 are unlikely to show progression requiring intervention in the absence of progressive neurological decline.[197] Radiographic imaging should be obtained immediately in the case of new neurological symptoms, headache, nausea, vomiting, or dizziness. Neurosurgical follow-up is essential.
One randomised controlled trial found no benefit for routine follow-up CT after surgery for chronic SDH and concluded CT may only be indicated if there is cause for concern (e.g., clinical deterioration or persisting neurological deficits).[198]
Use of this content is subject to our disclaimer