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KMID : 0385919930040020063
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Journal of the Korean Society of Emergency Medicine
1993 Volume.4 No. 2 p.63 ~ p.72
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A Clinical Analysis on the Management of Moderate Head Injury
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Abstract
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The aim of present study is to determine the initial treatment of patients who-appeared to have sustained moderate head injuries when first evaluated at the department of emergency medicine. The authors reviewed the records of 221 patients whose
initial
Glasgow coma scale (GCS) scores ranged from 9 to 12, as well as another 96 patients with GCS scores of 13. All patient underwent brain computed tomography (B-CT) at the time of initial evaluation. In 55.8% of these patients the B-CT were
abnormal,
and
33.4% required neurosurgical intervention. The overall mortality rate was 12.3%. Over forty percent of patients with GCS scores of 13 had abnormal lesion on B-CT and 12.5% of them required neurosurgical operation. This results suggest that an
initial
GCS scores of 13 should be classified as the moderate head injury group.
Above results indicate that all patients with moderate head injury on intial examination must be admitted to the hospital and undergo urgent B-CT. Patients with intracranial lesion require immediate neurosurgical consultation and admission to
critical-care unit. B-CT should be repeated in patients whose recovery is less rapid than expected and in all patients with evidence of clinical deterioration : this was necessary in almost half of the patient in this groups, and 19.2% were found
to
have progression of radiological abnormality or had newly developed lesion on serial B-CT.
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