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Intracranial injury after moderate head trauma in children

B W Rosenthal1, I Bergman

  • 1Department of Pediatrics, University of Pittsburgh School of Medicine, PA.

The Journal of Pediatrics
|September 1, 1989
PubMed

Insights

Most children with moderate head injuries and no skull fractures can be safely discharged from emergency care with proper observation. This finding aids in managing pediatric head trauma cases efficiently.

Area of Science:

  • Pediatric Emergency Medicine
  • Neurotrauma
  • Radiology

Background:

  • Moderate head injuries in children can lead to significant intracranial complications.
  • Accurate risk stratification is crucial for appropriate patient management and disposition.

Purpose of the Study:

  • To evaluate the incidence of intracranial complications in children with moderate head injuries.
  • To determine the predictive value of skull fractures in identifying children at risk for complications.

Main Methods:

  • Retrospective review of 459 pediatric patients with moderate head injuries and normal neurologic exams.
  • Analysis of skull X-ray findings and subsequent development of intracranial complications.

Main Results:

  • Skull fractures were identified in 14% of children who underwent X-ray.
  • Intracranial complications occurred in 1.3% of patients, all of whom had skull fractures.
  • Five cases of extradural hematomas and one of bifrontal contusions required surgical intervention.

Conclusions:

  • The absence of a skull fracture in alert, asymptomatic children with moderate head injury suggests a low risk of intracranial complications.
  • Children without skull fractures may be safely discharged under observation, optimizing emergency department resource allocation.

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