After brain surgery, bedside exam as critical as CT scan

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For brain surgery patients, a doctor’s bedside exam is still superior to a routine CT scan for identifying potential post-surgical complications, according to a study published in the Journal of Neurosurgery. Researchers from the Department of Neurological Surgery at Loyola University in Chicago examined the records of 251 patients who had a CT scan within 24 hours of brain surgery. Of these routine scans, 133 were performed within seven hours of surgery, and 108 were performed within 8 to 24 hours of surgery. Patients were also given bedside exams by physicians following surgeries. While none of the routine CT scans suggested that patients might be suffering from complications of surgery and need to return to the operating room, the doctors’ exams found that 10 patients were exhibiting potential evidence of complications—such as delayed ability to wake up—and when emergency CT scans were ordered for these patients, three ultimately had to return to the emergency room to address surgical complications.

The findings highlight not only the need for careful physician consultations in conjunction with CT scans, but suggest that doctors should be wary of simply accepting that initial CT scan results indicate that a patient is out of the woods. The danger of relying too heavily on scan results, the study authors argue, is that it may foster a sense of complacency among physicians and could lead to less careful monitoring of patients in the hours after surgery. Researchers point out that, of the 14 patients who ultimately experienced serious complications following surgery, 13 had been given good CT scan results within four hours of surgery.

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