Mild head injury

Assessment objectives

This report presents a critical review of the scientific literature on the care of mild head injury (commotio cerebri) in the acute phase. Current practice involves admitting the patient to a hospital for several days of observation. The hypothesis of this report suggests that it would be better and less costly to directly examine all patients by CT scanning to more quickly identify those with abnormal findings and to allow those who feel well and have normal findings to return home.

Assessment strategy

Systematic review of all scientific literature published from 1966 through 2000. Medline and the Cochrane Library were used to search the literature. Reference lists in important studies were also reviewed. Appropriate studies were selected by at least three of the authors independently.

Data collection

Only studies addressing the acute care phase of mild head injury were selected for review and quality assessment. A special review form was used in the selection process. Since severe complications from mild head injury are uncommon, descriptions of individual cases were also included.

Data criteria; types of studies included

No studies directly compare patient outcomes from the two strategies. To examine the relevant hypotheses indirectly, we used different types of study designs to assess and review the quality of the studies.

Review of publications

At least three of the authors assessed in detail and graded the quality of all selected studies and the facts extracted from them. The entire group supports the facts and conclusions related to the different areas. Four external reviewers and the SBU Scientific Advisory Committee reviewed the report, and it was revised to reflect their views. Thereafter, the SBU Board of Directors approved the conclusions.