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Beside Exams May Trump CT Scanning After Brain Surgery

Neurological exams more effectively identify serious complications than routine scanning

TUESDAY, Jan. 5 (HealthDay News) -- After patients undergo open brain surgery, a simple bedside examination may be more effective at identifying serious complications than routine computed tomography (CT) scanning, according to a study published online Dec. 18 in the Journal of Neurosurgery.

Ahmad Khaldi, M.D., of the Loyola University Chicago Stritch School of Medicine, and colleagues studied 133 patients who received routine scans within seven hours of surgery, and 108 patients who received routine scans between eight and 24 hours after surgery. All of the patients also received bedside neurological examinations.

The researchers found that the bedside examinations identified 10 cases of serious complications that warranted an urgent scan, three of which confirmed that the patients needed to undergo more surgery. However, they found that none of the 241 routine CT scans predicted which patients would require more surgery.

"Cost effective, evidence base care, requires judicious use of quantity and extent of technology," the authors conclude. "The low cost, simple but elegant neurological exam appears to be superior to a routine CT scan in determining return to operating room. Delaying the scan at least eight to 24 hours will maximize the benefit for both patient and managing physician."

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