A prospective study to identify high-yield criteria associated with acute intracranial computed tomography findings in head-injured patients

Am J Emerg Med. 1993 Jul;11(4):321-6. doi: 10.1016/0735-6757(93)90160-d.


We conducted a multicenter, prospective study of head-injured patients to identify high-yield clinical criteria for acute intracranial injuries. Emergency patients with a history of blunt head trauma occurring within 2 weeks and who underwent nonenhanced cranial computed tomography (CT) were entered onto the study during a 12-month period. Of the 264 patients, 32 (12%) had abnormal CT findings. Nine high-yield variables were associated with abnormal CT findings: alcohol use before injury, antegrade amnesia, prolonged loss of consciousness, anisocoria and/or fixed and dilated pupils, abnormal Babinski reflex, focal motor paralysis, cranial nerve deficit, Glasgow coma scale score of less than 15, and clinical signs of basilar skull fracture. Patients 2 years old or younger or older than 60 years of age showed a significantly greater prevalence of abnormal CT findings than patients of other ages.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Brain / diagnostic imaging
  • Brain Diseases / diagnosis*
  • Brain Diseases / diagnostic imaging
  • Brain Diseases / etiology
  • Brain Injuries / diagnosis*
  • Brain Injuries / diagnostic imaging
  • Brain Injuries / etiology
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / complications*
  • Emergency Service, Hospital
  • Female
  • Glasgow Coma Scale
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Physical Examination
  • Prognosis
  • Prospective Studies
  • Tomography, X-Ray Computed*