ACR Appropriateness Criteria® Head Trauma: 2021 Update.
Publication/Presentation Date
5-1-2021
Abstract
Head trauma (ie, head injury) is a significant public health concern and is a leading cause of morbidity and mortality in children and young adults. Neuroimaging plays an important role in the management of head and brain injury, which can be separated into acute (0-7 days), subacute (<3 >months), then chronic (>3 months) phases. Over 75% of acute head trauma is classified as mild, of which over 75% have a normal Glasgow Coma Scale score of 15, therefore clinical practice guidelines universally recommend selective CT scanning in this patient population, which is often based on clinical decision rules. While CT is considered the first-line imaging modality for suspected intracranial injury, MRI is useful when there are persistent neurologic deficits that remain unexplained after CT, especially in the subacute or chronic phase. Regardless of time frame, head trauma with suspected vascular injury or suspected cerebrospinal fluid leak should also be evaluated with CT angiography or thin-section CT imaging of the skull base, respectively. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Volume
18
Issue
5S
First Page
13
Last Page
13
ISSN
1558-349X
Published In/Presented At
Expert Panel on Neurological Imaging, Shih, R. Y., Burns, J., Ajam, A. A., Broder, J. S., Chakraborty, S., Kendi, A. T., Lacy, M. E., Ledbetter, L. N., Lee, R. K., Liebeskind, D. S., Pollock, J. M., Prall, J. A., Ptak, T., Raksin, P. B., Shaines, M. D., Tsiouris, A. J., Utukuri, P. S., Wang, L. L., & Corey, A. S. (2021). ACR Appropriateness Criteria® Head Trauma: 2021 Update. Journal of the American College of Radiology : JACR, 18(5S), S13–S36. https://doi.org/10.1016/j.jacr.2021.01.006
Disciplines
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
PubMedID
33958108
Department(s)
Department of Radiology and Diagnostic Medical Imaging
Document Type
Article
