{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:20:15Z","timestamp":1790079615691,"version":"4.0.1"},"reference-count":19,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>Moderate and severe traumatic brain injuries (TBI) are a major cause of severe morbidity and mortality; rapid diagnosis and management allow secondary injury to be minimized. Traumatic brain injury is only one of many potential causes of altered mental status; head computed tomography (HCT) is used to definitively diagnose TBI. Despite its widespread use and obvious importance, interpretation of HCT images is rarely covered by formal didactics during general surgery or even acute care surgery training. The schema illustrated here may be applied in a rapid and reliable fashion to HCT images, expediting the diagnosis of clinically significant traumatic brain injury that warrants emergent medical and surgical therapies to reduce intracranial pressure. It consists of 7 normal anatomic structures (cerebrospinal fluid around the brain stem, open fourth ventricle, \u201cbaby\u2019s butt,\u201d \u201cMickey Mouse ears,\u201d absence of midline shift, sulci and gyri, and gray-white differentiation). These 7 features can be seen even as the CT scanner obtains images, allowing the trauma team to expedite medical management of intracranial hypertension and pursue neurosurgical consultation prior to radiologic interpretation if the features are abnormal.<\/jats:p>","DOI":"10.1177\/0003134820973355","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T07:09:50Z","timestamp":1608534590000},"page":"1504-1510","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Rapid Detection of Significant Traumatic Brain Injury Requiring Emergency Intervention"],"prefix":"10.1177","volume":"87","author":[{"given":"Isaac W.","family":"Howley","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Tennessee Health Sciences Center, Memphis, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah M.","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco School of Medicine, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"bibr1-0003134820973355","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181bbfe2a"},{"key":"bibr2-0003134820973355","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.04.007"},{"key":"bibr3-0003134820973355","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2008.04711.x"},{"key":"bibr4-0003134820973355","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31815078ae"},{"key":"bibr5-0003134820973355","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1983.59.2.0285"},{"key":"bibr6-0003134820973355","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199209000-00009"},{"key":"bibr7-0003134820973355","first-page":"102","volume-title":"Advanced Trauma Life Support: Student Manual","author":"American College of Surgeons Committee on 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