Necessidade de tomografia computadorizada em pacientes com trauma cranioencefálico de grau leve

Giuliana Ribeiro Lesur; Mariana Baptista Nishida; José Mauro da Silva Rodrigues

doi:10.23925/1984-4840.2017v19i2a6

Authors

Giuliana Ribeiro Lesur Pontifícia Universidade Católica de São Paulo
Mariana Baptista Nishida Pontifícia Universidade Católica de São Paulo
José Mauro da Silva Rodrigues Pontifícia Universidade Católica de São Paulo

DOI:

https://doi.org/10.23925/1984-4840.2017v19i2a6

Keywords:

brain injuries, tomography, x-ray computed, wounds and injuries, Glasgow Coma Scale

Abstract

Introduction: Traumatic brain injury (TBI), defined as an injury caused to the brain by an external physical force, is measured by the Glasgow Coma Scale (GCS) and rated as severe (3–8), moderate (9–13) and mild (14 and 15). The TBI level is related to the injury, which is diagnosed by computed tomography (CT); however, this correlation does not always occur in mild TBI. Objective: To identify the profile of patients with mild TBI admitted at a trauma center and to verify if the routine use of CT benefits these patients. Methods: 45 CT reports were analyzed. The data collected was transcribed onto a form, which contained the patient’s evaluation using the GCS, for the ones classified as mild trauma patients, CT findings and CT indications. Results: Of these patients, 12 were at level 14 on the GCS and 33 were at level 15. Among the patients that required CT, 31 (68.9%) had lost consciousness, 3 (6.7%) were below level 15 on the GCS and up to 2 hours after admission, 1 (2.2%) had suspected skull damage, 7 (15.5%) were vomiting, 5 (11.1%) were older than 65 years, 14 (31.1 %) suffered from amnesia of events prior to trauma and 31 (68.9%) presented dangerous traumas. Five patients presented intracranial injuries and, among these, there was one with possible neurosurgical intervention. Conclusion: Patients with mild TBI, with least one of the signs or symptoms of the presence of injury, should undergo CT of the brain.

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Author Biographies

Giuliana Ribeiro Lesur, Pontifícia Universidade Católica de São Paulo

Acadêmica do sexto ano da FCMS- PUCSP

Mariana Baptista Nishida, Pontifícia Universidade Católica de São Paulo

Acadêmica do sexto ano da FCMS-PUCSP

José Mauro da Silva Rodrigues, Pontifícia Universidade Católica de São Paulo

Professor Associado do Departamento de Cirurgia da FCMS - PUCSPCoordenador do curso de medicina FCMS - PUCSPVice-presidente da SBAIT - Sociedade Brasileira de Atendimento Integrado ao TraumaTitular do CBC - Colégio Brasileiro de Cirurgiõe

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