Diagnosis and management of XXXX : a regional multicenter approach in Italy.

@entity1 @entity174 @entity542 @entity772 @entity1410
Two series of @entity1 admitted to the hospital after a @entity542 were collected in two different periods (1985 and 1989) in a regional hospital with a 24-hour computed tomography (CT) service, but without a neurosurgical unit. In 1988, a regional protocol on the management of @entity1 with @entity542 (based on the presence of skull @entity174 in adults and on clinical parameters in @entity1 ) was adopted. There was a 21% reduction in hospital admission in adults, and the number of skull x-ray films performed in @entity1 decreased significantly (p < 0.01). A more liberal use of CT examinations in asymptomatic @entity1 with skull @entity174 produced an earlier identification of @entity1 with extradural @entity1410 who were sent to neurosurgery before clinical deterioration with good results. Detection of cerebral contusions was clinically less important. Based on the availability of CT scanners in our area and on the results of our study, we have proposed new guidelines in management of @entity542 . The CT scans are obtained in @entity1 with a Glasgow @entity772 Scale score of 13 or less. Skull x-ray films are obtained in @entity1 older than 10 years with a Glasgow @entity772 Scale score of 14/15. If a @entity174 is found, the @entity1 is sent to the nearest regional center for CT examinations. @entity1 younger than 10 years are sent to a regional hospital with 24-hour CT availability for clinical observation or other indicated studies.
