Q; 72 year old male with chronic A. fib., on coumadin - admitted with fall and subdural hematoma. Patient was intubated in ER for the protection of airway. Neurosurgery service decided to follow the patient closely at this point. Ideally, at what interval CT scan of the head should be repeated?


Answer: Within 6-8 hours

Due to the danger of  rapid hematoma expansion, particularly in patients with clinical compromise, a quick follow up CT head should be performed.



References: 

Oertel M, Kelly DF, McArthur D, et al. Progressive hemorrhage after head trauma: predictors and consequences of the evolving injury. J Neurosurg 2002; 96:109. 

Servadei F, Nasi MT, Cremonini AM, et al. Importance of a reliable admission Glasgow Coma Scale score for determining the need for evacuation of posttraumatic subdural hematomas: a prospective study of 65 patients. J Trauma 1998; 44:868.