Spectrum of CT findings in patients with suspected acute traumatic brain injury. One year experience in Riga East Clinical University Hospital

Traumatic brain injury (TBI) is one of the most significant public health problems worldwide based on high incidence, prevalence, healthcare resource utilization, resulting death, disability and total economic cost. Emergency CT is method of choice in detecting treatable TBI before secondary neurological damage occurs. Aim of study was to assess spectrum and incidence of CT symptoms in patients with suspected TBI and correlate them with mechanism of injury, demographics, intoxication, and outcome. Retrospective study included 570 consecutive patients transported to Emergency department Riga Eastern University Hospital with suspected acute TBI between Jan 1 2019 and Dec 31 2019. All patients received emergency non-contrast head CT. Patients have been grouped according to obtained demographic, clinical, radiological data: gender, age, trauma mechanism, comorbidities, substance intoxication, hospitalization, surgery, outcome; CT signs of TBI: craniofacial, calvarias, scull base fractures; intracranial hemorrhage; contusions, secondary brain damage. Descriptive and analytical statistics was performed by SPSS software. Significance was considered with p<0.05. Patient’s age ranged from 18 to 101. There was predominance of men (M: F=3:2). CT signs of TBI (positive findings) were found in 175 cases (31%). TBI was most commonly found in middle-aged men, people with low socioeconomic status, alcohol users. Most common TBI mechanisms were falls (42%) and beatings (23%). 44 (26%) patients were hospitalized, 11 (6,3%) had surgery, 4 (2,3%) died. CT signs of TBI were extracranial soft tissue damage 133 (76%), bone fractures 47 (27%), craniofacial fractures -43, scull base fractures -10, calvarias factures -6; hemorrhagic brain contusions -18, SAH -17, SDH -16, IVH -3; secondary brain damage -8. Head CT in acute TBI is an indispensable tool of Emergency radiology department for verifying injury, need for surgery, predicting outcome. Still, the rational use of head CT scans to minimize unnecessary harm should be taken into consideration.