Theme
Diagnostic & Interventional Radiology
INSTITUTION
Taif University, College of Applied Medical Science, P.O. Box 2425, Post Code 21944, Taif KSA
Faculty of Radiology Science and Medical Imaging, Alzaiem Alazhari University, P.O. Box 1432, Khart
College of Medical Radiologic Science, Sudan University of Science and Technology, P.O. Box 1908, K
Head injuries are the main cause of death in Sudan. The emergency neurosurgery department of Teaching Khartoum Hospital, is the only specialized department in Sudan, which deals with the management of head injury patients.
Head injury, may be associated with skull fractures, which may cause intracranial haemorrhage, or brain tissue damage. The degree of severity of the injury varies from patient to another due to the type and violence of trauma and resultant fractures. Head injury may lead to complications which may lead in some cases to death. In the United Kingdom head trauma is responsible for more deaths in all age groups under 45 years old than any other single cause, and brain damage resulting from a head injury is the most important factor contributing to death or serious incapability due to trauma [1]. In 1981 the Royal Collage of Radiologists (RCR) supported a prospective study to investigate the use of skull radiography in the management of patients with head injury. Patients were divided into two categories: complicated head injury with additional injury or pathological findings and uncomplicated head injury [2]. The main investigations which were applied to diagnose the head injuries routinely is
conventional x-ray, which has low resolution and inefficient to demonstrate the brain tissues [2].
It has been discovered that X-rays are a part of electromagnetic radiation which are derived from electromagnetic spectrum. Because of their short wavelength, x-rays can penetrate materials which do not transmit light. They were discovered in 1895 by Conrad Roentgen who was a German physicist. X-rays are produced by a process which converts energy from one form into another. When fast moving electrons possess kinetic energy, which is converted into radiation energy when the electrons are suddenly slowed down [3]. Nevertheless, skull radiographs ordered routinely and with alacrity in most casualty departments to determine whether there is a skull fracture. Furthermore, there is the old medico-legal teaching that every head injury must have skull examination [4]. Computerized Tomography is a diagnostic Imaging procedure that uses a combination of X-ray (tomography) and computer technology to produce cross sectional images (slices) both horizontal and vertical of the body. Computerized tomography shows detailed images of any part of the body, including bones, muscles, fats and organs with more details [5]. The use of Computerized tomography in Sudan is not wide spread because the numbers of Computerized Tomography Centers are not more enough in Khartoum State, that receives all cases referred from hospitals, emergency departments and clinics.
This study is experimental, comparative study concerning with patients with head injuries in order to compare between CT and conventional skull X-ray investigations, the variables divided into two categories: Dependant variables like skull fractures, brain haemorrhage and independent variables: computerized tomography and conventional x-ray. The patients with
head injuries were selected to satisfy the need of the study. The data were collected by the technique of non probability method. The data collected by sheet which documented 250 random patients with head injuries. Those patients of different ages (1-80 years), sex (male- female), signs and symptoms referred to the emergency Neurosurgery Department at Khartoum Teaching Hospital. Their radiological investigations (Skull X-ray – CT scan brain) will be done in different X-ray Department & CT centers in Khartoum State, from June 2004 to February 2005.
The incidence of the head injuries is higher in males rather than females, and the occurrence had been at the age of 16-30 years. Most of the head injuries were caused by road traffic accidents (RTA) (158 cases – 63.2%). No difference between the CT scanning and the conventional skull x-ray in demonstrating the linear fractures of the skull (100% to 98.7%). The incidence of the head injuries is higher in males rather than females, and the occurrence had been at the age of 16-30 years. Most of the head injuries were caused by road traffic accidents (RTA) (158 cases – 63.2%).
Most of the head injuries were caused by road traffic accidents (RTA) (158 cases – 63.2%). No difference between the CT scanning and the conventional skull x-ray in demonstrating the linear fractures of the skull (100% to 98.7%). The conventional skull x-ray is capable to diagnose the depressed fractures of the skull as equal to the CT scanning does (100% CT- 94.9% skull x-ray). The conventional skull x-ray is sensitive to detect the compound fractures of the skull as well as the CT scanning (100% CT – 100% skull X-ray).
Authors appreciate Khartoum Teaching Hospital in Sudan for their contribution and efforts for this study during data collection phase.
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