ACR Appropriateness Criteria Head Trauma

Vilaas S. Shetty, Martin N. Reis, Joseph M. Aulino, Kevin L. Berger, Joshua Broder, Asim Choudhri, A. Tuba Kendi, Marcus M. Kessler, Claudia F. Kirsch, Michael D. Luttrull, Laszlo L. Mechtler, J. Adair Prall, Patricia B. Raksin, Christopher J. Roth, Aseem Sharma, O. Clark West, Max Wintermark, Rebecca S. Cornelius, Julie Bykowski

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Neuroimaging plays an important role in the management of head trauma. Several guidelines have been published for identifying which patients can avoid neuroimaging. Noncontrast head CT is the most appropriate initial examination in patients with minor or mild acute closed head injury who require neuroimaging as well as patients with moderate to severe acute closed head injury. In short-term follow-up neuroimaging of acute traumatic brain injury, CT and MRI may have complementary roles. In subacute to chronic traumatic brain injury, MRI is the most appropriate initial examination, though CT may have a complementary role in select circumstances. Advanced neuroimaging techniques are areas of active research but are not considered routine clinical practice at this time. In suspected intracranial vascular injury, CT angiography or venography or MR angiography or venography is the most appropriate imaging study. In suspected posttraumatic cerebrospinal fluid leak, high-resolution noncontrast skull base CT is the most appropriate initial imaging study to identify the source, with cisternography reserved for problem solving. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)668-679
Number of pages12
JournalJournal of the American College of Radiology
Volume13
Issue number6
DOIs
StatePublished - Jun 1 2016

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Craniocerebral Trauma
Neuroimaging
Closed Head Injuries
Phlebography
Guidelines
Chronic Brain Injury
Vascular System Injuries
Skull Base
Expert Testimony
Brain Injuries
Consensus
Angiography
Head
Therapeutics
Research
Traumatic Brain Injury

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Shetty, V. S., Reis, M. N., Aulino, J. M., Berger, K. L., Broder, J., Choudhri, A., ... Bykowski, J. (2016). ACR Appropriateness Criteria Head Trauma. Journal of the American College of Radiology, 13(6), 668-679. https://doi.org/10.1016/j.jacr.2016.02.023

ACR Appropriateness Criteria Head Trauma. / Shetty, Vilaas S.; Reis, Martin N.; Aulino, Joseph M.; Berger, Kevin L.; Broder, Joshua; Choudhri, Asim; Kendi, A. Tuba; Kessler, Marcus M.; Kirsch, Claudia F.; Luttrull, Michael D.; Mechtler, Laszlo L.; Prall, J. Adair; Raksin, Patricia B.; Roth, Christopher J.; Sharma, Aseem; West, O. Clark; Wintermark, Max; Cornelius, Rebecca S.; Bykowski, Julie.

In: Journal of the American College of Radiology, Vol. 13, No. 6, 01.06.2016, p. 668-679.

Research output: Contribution to journalArticle

Shetty, VS, Reis, MN, Aulino, JM, Berger, KL, Broder, J, Choudhri, A, Kendi, AT, Kessler, MM, Kirsch, CF, Luttrull, MD, Mechtler, LL, Prall, JA, Raksin, PB, Roth, CJ, Sharma, A, West, OC, Wintermark, M, Cornelius, RS & Bykowski, J 2016, 'ACR Appropriateness Criteria Head Trauma', Journal of the American College of Radiology, vol. 13, no. 6, pp. 668-679. https://doi.org/10.1016/j.jacr.2016.02.023
Shetty, Vilaas S. ; Reis, Martin N. ; Aulino, Joseph M. ; Berger, Kevin L. ; Broder, Joshua ; Choudhri, Asim ; Kendi, A. Tuba ; Kessler, Marcus M. ; Kirsch, Claudia F. ; Luttrull, Michael D. ; Mechtler, Laszlo L. ; Prall, J. Adair ; Raksin, Patricia B. ; Roth, Christopher J. ; Sharma, Aseem ; West, O. Clark ; Wintermark, Max ; Cornelius, Rebecca S. ; Bykowski, Julie. / ACR Appropriateness Criteria Head Trauma. In: Journal of the American College of Radiology. 2016 ; Vol. 13, No. 6. pp. 668-679.
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