The Value of Immediate Computerized Tomography Following Emergency Surgery for Traumatic Brain Injury: Experience in A Tertiary Center in Egypt

Abstract Background: Traumatic brain injury remains a major cause of death and disability all over the world. In Egypt it represents a major public health problem, representing 17.2% of trauma patients. Various factors determine the prognosis after TBI, the primary insult, which is irreversible and the secondary insults which continue to evolve during the subse-quent period after trauma. Aim of Study: In this study, we examined the value of immediate post-operative head CT scans in trauma patients to assess its efficacy and role in returning back to operation room. Results: We prospectively studied 145 patients with head injury who underwent surgery at Kasr Al-Ainy Hospitals during a period of 4 months between 10/2018 and 1/2019. All patients had immediate follow-up CT within 2 hours and another follow-up within 48 hours. The results of the immediate CT were: 121 cases improved (83.4%), expected worsening in 14 patients (9.7%) out of which 5 patients had redo surgery, unexpected worsening in 8 patients (5.5%) out of which 2 patients had redo surgery and 2 patients with unexpected new fining (none of them required redo). The 48 hours CT revealed no change in 133 patients (91.%), unexpected new finding in 12 patients (8.3%) most of these changes were in patients with ASDH. Conclusion: Unexpected change in the neurological ex-amination was the single most influential factor in determining the need for redo surgery. The low-cost, meticulous neurolog-ical examination appears to be superior to a routine CT scan in determining return to the operation room.