Comparative analysis of repeat cranial imaging in mild traumatic brain injury: evaluating risk factors, costs, and radiation exposure between 2017 and 2023
Background - A high number of repeat cranial imaging studies are performed on mild traumatic brain injury (mTBI) patients, but their diagnostic yield is often poor. This study assesses the impact of repeat imaging on patient management, including costs and radiation exposure. - Methods - We included...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
July 2026
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| In: |
World neurosurgery
Year: 2026, Volume: 211, Pages: 1-10 |
| ISSN: | 1878-8769 |
| DOI: | 10.1016/j.wneu.2026.124993 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.wneu.2026.124993 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1878875026002093 
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| Author Notes: | Elisabeth Jehli, Michael Kupka, David Bellut, Martin N. Stienen, Nicole C. Delgado Chavez, Luca Regli, Zsolt Kulcsar, Sandra Fernandes Dias |
| Summary: | Background - A high number of repeat cranial imaging studies are performed on mild traumatic brain injury (mTBI) patients, but their diagnostic yield is often poor. This study assesses the impact of repeat imaging on patient management, including costs and radiation exposure. - Methods - We included consecutive mTBI patients admitted to our trauma center in 2017 and 2023 who underwent clinical observation. We analyzed cranial computed tomography (CT) and imaging studies performed through 90-day follow-up, focusing on delayed neurosurgical intervention or death as primary endpoints. - Results - A total of 320 patients were included; intracranial hemorrhage (IH) was found in 98 patients in 2017 and 81 in 2023. Of those with IH at admission, 27% exhibited new or progressed IH on repeat imaging, leading to 11 delayed neurosurgical interventions due to clinical deterioration. Skull fractures were identified as predictors of IH progression. Patients on anticoagulants or antiplatelet medications without IH at admission had significantly more repeat CTs in 2017 compared to 2023. Notably, the total radiation exposure and imaging costs were higher in 2017, totaling 262′833 CHF. - Conclusions - While the risk of IH progression after mTBI is notable, repeat imaging minimally influences clinical decisions unless there is clinical deterioration. A trend toward fewer CTs and lower-dose radiation protocols was observed over the years, underscoring the need to optimize resource allocation for patients without IH on initial CT. |
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| Item Description: | Online verfügbar: 20. April 2026, Artikelversion: 21. Mai 2026 Gesehen am 25.06.2026 |
| Physical Description: | Online Resource |
| ISSN: | 1878-8769 |
| DOI: | 10.1016/j.wneu.2026.124993 |