Keywords:
Multicentre study, Observational, Retrospective, Haemorrhage, Acute, Audit and standards, CT, Trauma, Neuroradiology brain, Head and neck, Neuro
Authors:
S. Al-Ani, M. A. Hunter, C. M. Cameron; Glasgow/UK
DOI:
10.26044/ecr2020/C-02318
Purpose
Head injury is a common cause for presentation to the emergency department (ED) with an incidence quoted as 22.1 per 1000 person-years [1].
There is an increasing number of patients sustaining injury whilst being treated with traditional and novel anticoagulants (NOAC) with increasing number of CT scans of the head requested to exclude intracranial haemorrhage. It is important to manage these patients safely but avoid unnecessary imaging.
UK national guidelines (NICE) noted a paucity of evidence in determining whether these patients on NOAC are at increased risk of intracranial haemorrhage and recommended the decision to perform CT head on an individual basis, assuming no other criteria requiring imaging. [2]*. The aim of this study was to objectively evaluate this risk.
*Of note, the updated NICE guidelines in September 2019 now recommends CT head for patients with head injury and on anticoagulation with the scan performed within 8 hours of the injury and provisional radiology report provided within 1 hour of the scan being performed.