Abstract
In a review of the records of 874 head-injured patients who had an echoencephalogram in the Accident and Emergency Department, two patients with apparently 'minor' head injury subsequently developed an extradural haematoma. Both would have been diagnosed earlier if the results of the echoencephalogram had been used to influence their referral to the nearest neurosurgical department before the onset of any neurological deterioration. For those patients who arrive in the Department in coma, failure to detect any midline shift should not delay urgent referral for a CT scan. Such patients may be harbouring either bilateral haematomas or a very large single haematoma causing more than the 14-mm maximum shift recordable by the equipment.
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Selected References
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- Jeffreys R. V., Jones J. J. Avoidable factors contributing to the death of head injury patients in general hospitals in Mersey Region. Lancet. 1981 Aug 29;2(8244):459–461. doi: 10.1016/s0140-6736(81)90786-8. [DOI] [PubMed] [Google Scholar]
- Jennett B., MacMillan R. Epidemiology of head injury. Br Med J (Clin Res Ed) 1981 Jan 10;282(6258):101–104. doi: 10.1136/bmj.282.6258.101. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mendelow A. D., Karmi M. Z., Paul K. S., Fuller G. A., Gillingham F. J. Extradural haematoma: effect of delayed treatment. Br Med J. 1979 May 12;1(6173):1240–1242. doi: 10.1136/bmj.1.6173.1240. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mendelow A. D., Teasdale G., Jennett B., Bryden J., Hessett C., Murray G. Risks of intracranial haematoma in head injured adults. Br Med J (Clin Res Ed) 1983 Oct 22;287(6400):1173–1176. doi: 10.1136/bmj.287.6400.1173. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rose J., Valtonen S., Jennett B. Avoidable factors contributing to death after head injury. Br Med J. 1977 Sep 3;2(6087):615–618. doi: 10.1136/bmj.2.6087.615. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Teasdale G. Head injuries are badly managed in accident and emergency departments and neurosurgeons are partly to blame. Arch Emerg Med. 1984 Sep;1(3):123–134. doi: 10.1136/emj.1.3.123. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Teasdale G., Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974 Jul 13;2(7872):81–84. doi: 10.1016/s0140-6736(74)91639-0. [DOI] [PubMed] [Google Scholar]