SPJ Publication
The Radpac
Open Access Original Research

Repeat CT Brain Practices in Traumatic Brain Injury: An Observational Study

*

* Corresponding author: Deewakar Roy

Pages 1–4Language ENLicenceCC BY-NC 4.0XML metadata
  1. Received20 May 2025
  2. Accepted26 Jul 2025
  3. Published25 Aug 2025

Abstract

Background: Traumatic brain injury (TBI) remains a major cause of morbidity and mortality worldwide. Repeat CT brain imaging is often performed to monitor lesion progression and guide management, but its routine use may contribute to increased radiation exposure, cost, and resource utilization. This study evaluates repeat CT practices in TBI patients and assesses the clinical indications, timing, and outcomes associated with repeat imaging.

Materials andMethods: A prospective observational study was conducted over 3 months involving 156 TBI patients undergoing initial NCCT brain evaluation. Repeat CT scans were performed based on clinical indications and institutional protocols. Data on demographic profile, mechanism of injury, initial CT findings, timing of repeat CT, and changes in management were collected and analyzed.

Results: Repeat CT was performed in 68 (43.6%) patients. The most common indication for repeat CT was neurological deterioration (38.2%), followed by planned follow-up (29.4%) and suspicion of lesion progression (23.5%). Among repeat CTs, 35% showed progression, 52% remained stable, and 13% showed improvement. Repeat CT findings resulted in management change in 28% of cases, including surgical intervention and ICU transfer.

Conclusion: Repeat CT brain imaging in TBI patients is frequently used, primarily driven by clinical deterioration and monitoring protocols. While many repeat scans show stable findings, a significant proportion reveal progression requiring intervention. Rationalizing repeat CT practices based on clinical indicators may optimize resource utilization and reduce unnecessary radiation exposure.

Keywords

Repeat CTTraumatic Brain InjuryNeuroimagingLesion ProgressionRadiation Exposure.

References

  1. Beedkar S, Prasad GL, Menon G. Role of scheduled repeat CT scan in traumatic brain injuries: a prospective observational study. Surg Neurol Int. 2024;15:317. doi:10.25259/SNI_376_2024.

  2. Connon FF, Namdarian B, Ee JLC, Drummond KJ, Miller JA. Do routinely repeated computed tomography scans in traumatic brain injury influence management? A prospective observational study in a level 1 trauma center. Ann Surg. 2011;254(6):1028-31. doi:10.1097/SLA.0b013e318219727f.

  3. Brown CV, Zada G, Salim A, Inaba K, Kasotakis G, Hadjizacharia P, et al. Indications for routine repeat head computed tomography (CT) stratified by severity of traumatic brain injury. J Trauma. 2007;62(6):1339-44. doi:10.1097/TA.0b013e318054e25a.

  4. Shah JM, Shah KS, Kumar J, Sundaram PK. Role of routine repeat computed tomography of brain in patients with mild and moderate traumatic brain injury: a prospective study. Asian J Neurosurg. 2017;12(3):412-5. doi:10.4103/1793-5482.180968.

  5. Ding J, Yuan F, Guo Y, Chen SW, Gao WW, Wang G, et al. A prospective clinical study of routine repeat computed tomography (CT) after traumatic brain injury (TBI). Brain Inj. 2012;26(10):1211-6. doi:10.3109/02699052.2012.667591.

  6. Joseph B, Aziz H, Pandit V, Kulvatunyou N, Hashmi A, Sadoun M, et al. A three-year prospective study of repeat head computed tomography in patients with traumatic brain injury. J Am Coll Surg. 2014;219(1):45-51. doi:10.1016/j.jamcollsurg.2013.12.062.

  7. Rosen CB, Luy DD, Deane MR, Scalea TM, Stein DM. Routine repeat head CT may not be necessary for patients with mild TBI. Trauma Surg Acute Care Open. 2018;3(1):e000129. doi:10.1136/tsaco-2017-000129.

  8. Brown CV, Weng J, Oh D, Salim A, Kasotakis G, Demetriades D, et al. Does routine serial computed tomography of the head influence management of traumatic brain injury? A prospective evaluation. J Trauma. 2004;57(5):939-43.

  9. Ding J, Guo Y, Chen SW, Wang G, Gao WW, Chen H, et al. Clinical study of routine repeat CT after traumatic brain injury. J Shanghai Jiaotong Univ (Med Sci). 2011;31(6):793. doi:10.3969/j.issn.1674-8115.2011.06.024.

  10. Almenawer SA, Alshameeri Z, Macdonald RL, et al. The value of repeat head computed tomography in patients with traumatic brain injury: a systematic review and meta-analysis. Neurosurgery. 2013;73(5):797-806.