Follow-up CT imaging in patients with traumatic brain injury in Zimbabwe

Abstract

Purpose To assess the type and degree of neurological complications in patients with traumatic brain injury (TBI) who presented with an initial typical baseline computed tomography (CT) brain scan and to assess the time in which neurological complications developed. Methods A retrospective cross-sectional quantitative research design was conducted in which CT radiology reports of 85 adult patients with TBI and typical baseline CT scans were analyzed during a 2-year period. The evolution of different types of neurological pathology diagnosed on follow-up CT brain imaging in these patients was recorded and analyzed. Results The results showed that 36% of patients (n  31) presented with atypical neuroradiological findings on follow-up CT imaging. Subdural hematoma was diagnosed in 19% (n  16), intracerebral hematoma in 8% (n  7), subarachnoid hematoma in 6% (n  5), pneumocephalus in 2% (n  2), and epidural hematoma in 1% (n  1). The average times elapsed between the traumatic event and acquisition of the baseline CT brain scan and follow-up CT were 8 and 18 hours, respectively. Discussion The most common causal mechanism of trauma in this study was motor vehicle collisions; an increase in motor vehicle collisions might have resulted in many vulnerable road users on poor road infrastructure and communities living in the vicinity of such roads. The severity of neurological status of patients might be associated with a higher likelihood of detecting intracranial pathology on follow-up CT brain imaging. Follow-up CT brain imaging findings have a role in confirming or excluding late neurological complications preceded by a typical baseline CT brain scan. Conclusion Follow-up CT brain imaging performed at 10 hours after the typical baseline CT scan was of value in detecting the evolution of intracranial neurological pathology and resulted in a change in neurological management in one-third of patients.