Abstract: Background: Cranial computed tomography scan is a
routinely performed investigation in the evaluation of head injury cases. These
scans detect the pathologies caused by the trauma as well as many unexpected
incidental findings, the frequency of which are not known. Present study was
conducted with the objectives to evaluate the patients with head injury using
computed tomography and to determine the prevalence and significance of
incidental findings on cranial scans.
Materials and Methods: This prospective study was conducted in Deccan
College of Medical Sciences, Hyderabad, Telangana. A total of 600 consecutive
patients of all age groups with history of head trauma undergoing cranial scans
were included in this study. Computed tomographic scans of the brain are
obtained from the vertex to foramen magnum level. Two series of axial data sets
are obtained, one using soft tissue and another with bone-reconstruction
algorithms. Collected data was entered in excel sheets and simple descriptive
statistics were used to describe in the form of frequency tables and graphs.
Results: The detected incidental findings were divided
into two categories based on the plan of management. The mean patient age was
40+/-15.3 years, and male to female ratio was 2: 1. Incidental finding were
identified in 28.5% of study sample which were mostly benign and non-critical.
Arachnoid cysts (8%), megacisterna magna (5.8%) and calcified granulomas (8.8%)
are the commonly noted incidental findings in category 1 and neuroparenhcymal
atrophy (7.1%), infarcts (8.7%) and brain tumors (2%) are the commonly
identified pathologies in category 2.
Conclusion: The incidentally detected findings are both
critical and noncritical pathologies. Although most of them are benign, it is
important to mention about the findings in the report for counseling and
management of the condition and to prevent further complications in future.
