evaluation of incidental findings in brain ct scans of mild head trauma patients (gcs: thirteen to fifteen)

background: to determine the prevalence of incidental findings on brain ct scan in mild head trauma patients. methods: from november 2005 to april 2006, we evaluated 732 ct scans of cases with mild head trauma (glasgow coma scale score of thirteen, fourteen, and fifteen), whom referred to our university affiliated hospital. in this study, we evaluated incidental findings on brain ct of our patients, as well as size of the cistern magna. results: five hundred (68.3%) of our patients were male and 232 (31.7%) were female. the mean age of our cases were 27.4±19.2 (one month to 89 years old).incidental findings were found on 22 cases (3.1%).among these, there were five tumors (0.7%), eight arachnoids cysts (1.1%), and five bones lesions (0.7%). large cisterna magna (>10 cm 3 ) was seen in four cases. incidental findings in males were seen in ten cases (45%) and in females were seen in 12 cases (55%) (p=0.019). the mean age of cases with incidental findings were 37.2±20.6 years and in cases without incidental findings were 27.1±19.1 years (p=0.011). conclusion: in this study we found that arachnoid cyst was the most common incidental finding, and brain tumor and bone lesions were next common ones. keywords: incidental findings; computerized tomography; head injury references 1. rudick ra. asymptomatic intracerebral hematoma as an incidental finding. arch neurol 1981; 38:396- 7. 2. weisberg la. incidental focal intracranial computed tomography findings. j neurol neurosurgery psychiatry 1982; 45:715- 18. 3. wood mw, white rj, kernohan jw. one hundred intracranial meningiomas found incidentally at necropsy. j neuropathology exp neurol 1957; 16: 337- 40. 4. aaron dc, howlett ta. pituitary incidentalomas. endocrinol metab clin north am 2000; 29:205- 21. 5. feldkamp j, santen r, harms e, aulich a, modder u, scherbaum wa. incidentally discovered pituitary lesions: high frequency of macro adenomas and hormone-secreting adenomas-results of prospective study. clin endocrinol 1999; 51:109-13. 6. molitch me. evaluation and treatment of the patient with a pituitary incidentaloma. j  clin endocrinol metab 1995; 80:3 -6. 7. nishizawa s, ohta s, yokoyama t, uemura k. therapeutic strategy for incidentally found pituitary tumors  (pituitary incidentalomas). neurosurgery 1998; 43(6):13 44- 8; discussion 1348-50. 8. tomita t, gates e. pituitary adenomas and granular cell tumors. am j clin pathol 1999; 111:817 - 25. 9. nakamura m, roser f, michel j, jacobs c, samii m. the natural history of incidental meningiomas.neurosurgery 2003; 53:62- 71. 10. harrington mg, macpherson p, mcintosh wb, allam bf, bone i. the significance of the incidental finding of basal ganglia calcification on computed tomography. j neurol neurosurgery psychiatry 1981; 44:1168- 70. 11. eskandary h, sabba m, khajehpour f, eskandari m. incidental findings in brain computed tomography scans of 3000 head trauma patients. surg neurol 2005 jun; 63(6):550-3; discussion 553. 12. katzman gl, dagher ap, patronas nj. incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers.  jama. 1999 jul 7; 282(1):36-9. 13. wester k. gender distribution and sidedness of middle fossa arachnoids cysts: a review of cases diagnosed with computed imaging. neurosurgery 1992; 31: 940 -4. 14. flaherty aw. the massachusetts general hospital handbook of neurology 2000 jan; 1:105. 15. robinson rg. congenital cysts of the brain: arachnoids malformation. prog neural surg 1971; 4:133 - 74. 16. shuangshoti s. calcified congenital arachnoids cyst with heterotopic neuroglia in wall. j neurol neurosurg psychiatry 1978; 41:88 - 94. 17. kelly cb, walter oa. ct scan findings in mild head trauma a series of 2,000 patients. arq neuropsiquiatr 2002; 60(2-a):204-10. 18. jennet b. epidemiology of head injury. j neurol neurosurg psychiatry 1996; 60: 362-9. 19. green jr, waggener jd, kriegsfeld ba. classification and incidence of neoplasms of the central nervous system. adv neurol 1976; 15:51- 5. 20.  marszal e, jamroz e, pilch j. agenesis of corpus callosum: clinical description and etiology. j child neurol 2000 jun; 15(6): 401-5. 21. adam r, greenberg jo. the mega cisterna magna. j neurosurgery 1978; 48:190- 2. 22. bernard jp, moscoso g, renier d, ville y. cystic malformations of the posterior fossa. prenat diagn 2001; 21:1064–9.