Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification in cases of unclear unconsciousness
- Computed tomography of the skull (cranial CT, cranial CT or cCT) or magnetic resonance imaging (MRI) of the skull (cranial MRI).
- Abdominal sonography (ultrasound examination of the abdominal organs) – for basic diagnostics.
- X-ray of the thorax (X-ray thorax / chest), in two planes.
Additional notes
The Centers for Disease Control and Prevention advises against regular imaging procedures such as computed tomography (CT) or magnetic resonance imaging (MRI) in cases of mild traumatic brain injury (TBI; Glasgow Coma Scale 15; see below Craniocerebral Trauma/Classification)…. On CT, intracranial (“inside the skull“) injuries are found in approximately 7.5%, are of clinical relevance in 1.9%, and require neurosurgical intervention in 0.8%. Instead, clinical risk assessment should be performed because TBI can also develop “dynamically”.Risk factors include:
- Age (children <2 years are more likely to be at risk).
- Vomiting
- Prolonged unconsciousness
- Amnesia (memory impairment)
- Glasgow Coma Scale score < 15
- Injury mechanism (to be considered)
- Non-frontal scalp hematoma (“bruise of the scalp not belonging to the forehead”).
- Clinical suspicion of a skull fracture (skull fracture).
- Headache that is severe and worsening
Note: 70-80% of children recover within 1 to 3 months after mild traumatic brain injury.
