>> You'd be
>> amazed at how many seemingly 'minor' head injuries have clinically
>> significant intracerebral injuries if you actually scan them.........
>
>What is clinically significant in this context? Do you mean that CT
>materially affected management? Surely the management of many of these
>injuries is identical to that if the CT had been normal - observation and
>rehab? It provides prognostic value, but is this clinically significant at
4 in the morning?
And more important, is clinically significant the same as a proven
improvement in outcome? We used to find that many over 65s, especially if
on aspirin, had small bleeds. So they were then admitted for 24h and
discharged the next day, rather than being sent home with a carer. I don't
think any of it had an effect on long term prognosis, it just filled up
more beds (usually in the ED, which was the default overflow ward for these
patients).
Fiona.
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