The role of plain skull films in the evaluation of head injury at the Kenyatta National Hospital

Abstract

This one year (1-6-96 to 1-6-97) retrospective study was carried out at the X-ray department of the Kenyatta National Hospital (KNH) to evaluate the role of plain skull radiographs in cases of head injury. Atotal of 1093 records whose clinical diagnosis was head injury were reviewed. Of these, 1011 (92.5%) had no fracture demonstrated. Only 82 (7.5%) demonstrated skull fracture. With such low yield it was necessary to carry out this survey.to establish the role of plain skull radiographs in the evaluation of head injury. Plain skull x-ray was found to be unnecessarily requested in the evaluation of head injury at the

KenyattaNational Hospital. Assault was the commonest cause of head trauma 463 (42.4%), followed by Road traffic accidents369 (33.8%), falls 99 (9.1 %), others 38(3.5%). Maleprepoderance was shown at all age groups and in all causes of head injury. Of the 82 patients who had fractures of the skull on plain film, one had CT scan done due to deterioratingcondition; and no intracranial brain injury was shown. A further 2 patients who had normalskull x-rays were also done CT scan due to deteriorating conditions and both had

epidural haematomas and no cranial bone fracture was shown, hence the importance of full clinicalassessment other than relying on radiological diagnosis.