Incidental Findings on Computed Tomographic scans in Patients with Head Trauma in Ilorin, Nigeria
Article Sidebar
Views | PDF/EPUB Downloads:
16
/ 3
/ 3
Main Article Content
Abstract
Background/Aims: The focus of computed tomography (CT) examination in patients with suspected traumatic brain injury (TBI) is to assess the damage to cranial structures as a result of trauma; however, sometimes findings unrelated to the chief complaint and not pertinent to the immediate patient care are discovered. These findings are classified as “incidental findings.” The aim of the study is to determine the prevalence of incidental findings discovered during CT examinations in patients with suspected TBI in our environment.
Materials and Methods: A retrospective study of 551 patients with TBI, referred for CT examination at the Radiology Department of the University of Ilorin Teaching Hospital (UITH), Ilorin from January 2009-2013. Any non-traumatic findings on CT scan or findings that were not related to the chief complaint were considered “incidental findings.”
Results: Incidental findings were seen in 19 (3.4%) patients, 12 (2.2%) males and 7 (1.2%) females. Enlarged cisterna magna was the commonest finding occurring in 5 (0.9%) patients. Meningiomas were the commonest incidental brain tumor found in 3 (0.54%) patients. Other incidental lesions include lacunar infarcts, arachnoid cyst, neuroglial cyst, and osseous lesions.
Conclusion: Clinically serious incidental findings were mainly brain tumors. Visual abnormalities resulting from an incidental suprasellar meningioma may actually predispose to TBI as the patient was found to be responsible for the road traffic accident in which the head injury was sustained. However, larger studies involving many centers may be needed to correlate the role of serious incidental findings vis a vis predisposition to road traffic accidents.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
How to Cite
References
1. Illes J, Kirschen MP, Edwards E, Stanford LR, Bandettini P, Cho MK, et al., Working Group on Incidental Findings in Brain Imaging
Research. Ethics: Incidental findings in brain imaging research. Science 2006;311:783‑4.
2. Wolf SM, Lawrenz FP, Nelson CA, Kahn JP, Cho MK, Clayton EW, et al. Managing incidental findings in human subjects research: Analysis andrecommendations. J Law Med Ethics 2008;36:219‑48.
3. Mold JW, Stein HF. The cascade effect in the clinical care of patients. N Engl J Med 1986;314:512‑4.
4. Lumbreras B, Donat L Hernández‑Aguado I. Incidental findings in imaging diagnostic tests: A systematic review. Br J Radiol 2010; 83:276‑89.
5. Paluska TR, Sise MJ, Sack DI, Sise CB, Egan MC, Biondi M, et al. Incidental CT findings in trauma patients: Incidence and implications for care of the injured. J Trauma 2007;62:157‑61.
6. Eskandary H, Sabba M, Khajehpour F, Eskandari M. Incidental findings in braincomputed tomography scans of 3000 head trauma
patients. Surg Neurol 2005;63:550‑3.
7. Munk MD, Peitzman AB, Hostler DP, Wolfson AB. Frequency and follow‑up of incidental findings on trauma computed tomography
scans: Experience at a level one trauma center. J Emerg Med 2010;38:346‑50.
8. Sanei TM, Hemadi H, Sajadi NM, Jalali AH, Eftekharpour D. Evaluation of incidental findings in brain CT scans of mild head trauma patients (GCS: Thirteen to fifteen). Iranian J Cancer Prev 2010;3:32‑5.
9. Morris Z, Whiteley WN, Longstreth WT Jr, Weber F, Lee YC, Tsushima Y, et al. Incidental findings on brain magnetic resonance
imaging: Systematic review and meta‑analysis. BMJ 2009;339:b3016.
10. Ortega HW, Vander Velden H, Reid S. Incidental findings on computed tomography scans in children with mild head trauma.
Clin Pediatr (Phila) 2012;51:872‑6.
11. Zimmer EZ, Lowenstein L, Bronshtein M, Goldsher D, Aharon‑Peretz J. Clinical significance of isolated mega cisterna magna. Arch Gynecol Obstet 2007;276:487‑90.
12. Haimovici JA, Doubilet PM, Benson CB, Frates MC. Clinical significance of isolated enlargement of the cisterna magna (>10 mm)
on prenatal sonography. J Ultrasound Med 1997;16:731‑4.
13. Aron DC, Howlett TA. Pitituary incidentalomas. Endocrinol Metab Clin North Am 2000;29:205‑21.
14. Radhakrishnan K, Mokri B, Parisi JE, O’Fallon WM, Sunku J, Kurland LT. The trends in incidence of primary brain tumors in the population of Rochester, Minnesota. Ann Neurol l995;37:67‑73.
15. Nakamura M, Roser F, Michel J, Jacobs C, Samii M. The natural history of incidental meningiomas. Neurosurgery 2003;53:62‑70.
16. Vernooij MW, Ikram MA, Tanghe HL, Vincent AJ, Hofman A, Krestin GP, et al. Incidental findings on brain MRI in the general
population. N Engl J Med 2007;357:1821‑8.
17. Molitch ME, Russell EJ. The pituitary “incidentaloma”. Ann Intern Med 1990;112:925‑31.
18. Serhal D, Weil RJ, Hamrahian AH. Evaluation and management of pituitary incidentalomas. Cleve Clin J Med 2008;75:793‑801.
19. Vermeer SE, Koudstaal PJ, Oudkerk M, Hofman A, Breteler MM. Prevalence and incidence of silent brain infarct in the population‑based Rotterdam Scan Study. Stroke 2002;33:21‑5.
20. Brown JJ, Hesselink JR, Rothrock JF. MR and CT of Lacunar infarcts. AJR Am J Roentgenol 1988;15:367‑72.
21. Wester K. Gender distribution and sidedness of midfossa arachnoid cysts: A review of cases diagnosed with computed imaging.
Neurosurgery 1992;31:940‑4.
22. Rogers AJ, Maher CO, Schunk JE, Quayle K, Jacobs E, Lichenstein R, et al., Pediatric Emergency Care Applied Research Network. Incidental findings in children with blunt head trauma evaluated with cranial CT scans. Pediatrics 2013;132:e356‑63.
23. Osborn AG, Preece MT. Intracranial cysts: Radiologic‑pathologic correlation and imaging approach. Radiology 2006;239:650‑64.
24. Gutknecht DR. Meador revisited: Nondisease in the nineties. Ann Intern Med 1992;116:873‑4.
25. Royal HD, Siegel BA, Murphy WA Jr. An incidental finding: A radiologist’s perspective. AJR Am J Roentgenol1993;160:237‑40.
26. Yue NC, Longstreth WT Jr, Elster AD, Jungreis CA, O’Leary DH, Poirier VC. Clinically serious abnormalities found incidentally at MR imaging of the brain: Data from the Cardiovascular Health Study. Radiology 1997;202:41‑6.
27. Sandeman EM, Hernandez MD, Morris Z, Bastin ME, Murray C, Gow AJ, et al. Incidental findings on brain MR imaging in older
community‑dwelling subjects are common but serious medical consequences are rare: A cohort study. PLoS One 2013;8:e 71467.
28. The Royal College of Radiologists. Management of incidental findings detected during research imaging. London: Royal College
of Radiologists; 2011 . p. 6.