Several years ago, every patient that was brought to Thomas Jefferson University Hospital with a closed head injury would receive a CT scan — regardless of whether or not that patient already had a scan performed at an outside institution. If the scan demonstrated any intracranial pathology, then a repeat CT scan was performed 12 hours after the initial scan as long as the patient remained neurologically stable. Ultimately, every patient received two CT scans at our institution separated by 12 hours. Now, each patient is followed by a total of three CT scans. If a patient had undergone a CT scan at an outside institution, this scan was loaded onto the Jefferson system and was considered their first CT scan. A follow-up CT scan was to be performed 6 hours after the initial scan if any intracranial pathology was noted. As long as the patient remained neurologically stable, a third and final CT scan was to be performed sometime between 12 to 24 hours after the initial scan. Therefore, patients with non-operative intracranial hemorrhage received two or three CT scans at our institution and were observed for at least 24 hours.
Wu, Chengyuan and Jallo, Jack
"Developing a Clinical Guideline for CT Scans in Closed Head Injury,"
JHN Journal: Vol. 6
, Article 3.
Available at: http://jdc.jefferson.edu/jhnj/vol6/iss1/3