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Significance of vomiting after head injury

P A Nee1, J M Hadfield, D W Yates

  • 1Accident and Emergency Department, Whiston Hospital, Merseyside, UK.

Journal of Neurology, Neurosurgery, and Psychiatry
|April 14, 1999
PubMed

Insights

Post-traumatic vomiting, even a single episode, significantly increases the risk of skull fractures in both adults and children. This finding suggests vomiting should be a key factor in head injury assessments.

Area of Science:

  • Trauma care
  • Emergency medicine
  • Pediatric neurology

Background:

  • Head injuries are common, and identifying fracture risk is crucial.
  • Skull vault fractures require prompt diagnosis and management.
  • Predictive factors for skull fractures are essential for clinical decision-making.

Purpose of the Study:

  • To investigate the association between post-traumatic vomiting and skull vault fractures.
  • To determine if the severity of vomiting impacts fracture risk.
  • To evaluate vomiting as a predictor in adult and pediatric head injury patients.

Main Methods:

  • Analysis of 5416 consecutive head injury patients presenting to UK emergency services.
  • Inclusion of demographic, injury, and clinical data, including vomiting.
  • Statistical analysis to assess the relative risk of skull fracture associated with vomiting.

Main Results:

  • Post-traumatic vomiting occurred in 7% of adults and 12% of children.
  • Patients with skull fractures had a higher incidence of vomiting (28% adults, 33% children).
  • Vomiting quadrupled the relative risk of skull fracture; nausea alone did not increase risk.

Conclusions:

  • Enquiry about vomiting should be integrated into skull radiography guidelines.
  • A single episode of vomiting is as significant as multiple episodes for fracture risk.
  • Vomiting is a valuable indicator for skull fracture risk assessment in head-injured patients.
Abstract

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