Background: Routine repeat CT head imaging of trauma patients with Traumatic Brain Injury (TBI) within 24 hours has been a standard of practice. However, the literature does not show the optimal timing of these repeat CT scans to determine need for neurosurgical intervention. The objective of our study is to determine the optimal timing of routine repeat head CTs (CTH) in patients with TBI to assess for progression of injury and determine need for neurosurgical intervention. We hypothesized that patients with a change in Glasgow coma scale (GCS) receiving repeat CTH would show progression and a higher rate of neurosurgical intervention. Methods: Retrospective study was performed at a level 2 trauma center and included patients from January 2020 to January 2022. All patients diagnosed with a TBI on initial CTH who did not undergo immediate neurosurgical intervention and underwent a repeat interval CTH were included. Univariate analysis was used to assess patients who underwent intervention vs those who did not to compare the role of early repeat CT imaging. Results: 560 patients fulfilled inclusion criteria. 15 patients (2.7%) required neurosurgical intervention after repeat imaging. There was a significantly higher proportion of interval repeat CTH performed early (within 12 hours) in patients ultimately undergoing neurosurgical intervention compared with those that did not (0.80 vs 0.473, p=0.0165). The patients taken for intervention after repeat imaging had a significantly higher ISS (p= 0.0001) and tended to have a lower GCS on admission (p=0.0573). Conclusion: These findings suggest that there is value in obtaining early repeat CTH (< 12 hours) in carefully selected populations that may include more injured patients or patients with a lower admission GCS. However, identification of this high-risk population requires further analysis.
| Published in | Journal of Surgery (Volume 13, Issue 2) |
| DOI | 10.11648/j.js.20251302.12 |
| Page(s) | 41-44 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2025. Published by Science Publishing Group |
Mild Traumatic Brain Injury, Imaging, Head Injury, Repeat Head CT, Injury Severity Score (ISS), Glasgow Coma Scale (GCS)
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APA Style
Michos, L., Gummadi, S., Galloway, O., Kohli, A. (2025). The Role of Early Repeat CT Imaging in Traumatic Brain Injury. Journal of Surgery, 13(2), 41-44. https://doi.org/10.11648/j.js.20251302.12
ACS Style
Michos, L.; Gummadi, S.; Galloway, O.; Kohli, A. The Role of Early Repeat CT Imaging in Traumatic Brain Injury. J. Surg. 2025, 13(2), 41-44. doi: 10.11648/j.js.20251302.12
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Download@article{10.11648/j.js.20251302.12,
author = {Lia Michos and Sriharsha Gummadi and Olivia Galloway and Anirudh Kohli},
title = {The Role of Early Repeat CT Imaging in Traumatic Brain Injury
},
journal = {Journal of Surgery},
volume = {13},
number = {2},
pages = {41-44},
doi = {10.11648/j.js.20251302.12},
url = {https://doi.org/10.11648/j.js.20251302.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20251302.12},
abstract = {Background: Routine repeat CT head imaging of trauma patients with Traumatic Brain Injury (TBI) within 24 hours has been a standard of practice. However, the literature does not show the optimal timing of these repeat CT scans to determine need for neurosurgical intervention. The objective of our study is to determine the optimal timing of routine repeat head CTs (CTH) in patients with TBI to assess for progression of injury and determine need for neurosurgical intervention. We hypothesized that patients with a change in Glasgow coma scale (GCS) receiving repeat CTH would show progression and a higher rate of neurosurgical intervention. Methods: Retrospective study was performed at a level 2 trauma center and included patients from January 2020 to January 2022. All patients diagnosed with a TBI on initial CTH who did not undergo immediate neurosurgical intervention and underwent a repeat interval CTH were included. Univariate analysis was used to assess patients who underwent intervention vs those who did not to compare the role of early repeat CT imaging. Results: 560 patients fulfilled inclusion criteria. 15 patients (2.7%) required neurosurgical intervention after repeat imaging. There was a significantly higher proportion of interval repeat CTH performed early (within 12 hours) in patients ultimately undergoing neurosurgical intervention compared with those that did not (0.80 vs 0.473, p=0.0165). The patients taken for intervention after repeat imaging had a significantly higher ISS (p= 0.0001) and tended to have a lower GCS on admission (p=0.0573). Conclusion: These findings suggest that there is value in obtaining early repeat CTH (< 12 hours) in carefully selected populations that may include more injured patients or patients with a lower admission GCS. However, identification of this high-risk population requires further analysis.
},
year = {2025}
}
TY - JOUR T1 - The Role of Early Repeat CT Imaging in Traumatic Brain Injury AU - Lia Michos AU - Sriharsha Gummadi AU - Olivia Galloway AU - Anirudh Kohli Y1 - 2025/05/19 PY - 2025 N1 - https://doi.org/10.11648/j.js.20251302.12 DO - 10.11648/j.js.20251302.12 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 41 EP - 44 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20251302.12 AB - Background: Routine repeat CT head imaging of trauma patients with Traumatic Brain Injury (TBI) within 24 hours has been a standard of practice. However, the literature does not show the optimal timing of these repeat CT scans to determine need for neurosurgical intervention. The objective of our study is to determine the optimal timing of routine repeat head CTs (CTH) in patients with TBI to assess for progression of injury and determine need for neurosurgical intervention. We hypothesized that patients with a change in Glasgow coma scale (GCS) receiving repeat CTH would show progression and a higher rate of neurosurgical intervention. Methods: Retrospective study was performed at a level 2 trauma center and included patients from January 2020 to January 2022. All patients diagnosed with a TBI on initial CTH who did not undergo immediate neurosurgical intervention and underwent a repeat interval CTH were included. Univariate analysis was used to assess patients who underwent intervention vs those who did not to compare the role of early repeat CT imaging. Results: 560 patients fulfilled inclusion criteria. 15 patients (2.7%) required neurosurgical intervention after repeat imaging. There was a significantly higher proportion of interval repeat CTH performed early (within 12 hours) in patients ultimately undergoing neurosurgical intervention compared with those that did not (0.80 vs 0.473, p=0.0165). The patients taken for intervention after repeat imaging had a significantly higher ISS (p= 0.0001) and tended to have a lower GCS on admission (p=0.0573). Conclusion: These findings suggest that there is value in obtaining early repeat CTH (< 12 hours) in carefully selected populations that may include more injured patients or patients with a lower admission GCS. However, identification of this high-risk population requires further analysis. VL - 13 IS - 2 ER -
Department of Surgery, Thomas Jefferson University, Philadelphia, United States
Department of Surgery, Thomas Jefferson University, Philadelphia, United States
Department of Surgery, Washington University Medical Center, St. Louis, Missouri
Department of Surgery, Thomas Jefferson University, Philadelphia, United States
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