Skull x-rays in head trauma: are they still necessary? A review of 1000 cases

One thousand consecutive skull x-rays in patients with head trauma were reviewed. Only eighteen (1.8%) showed a fracture. Four of these were depressed. Thirteen of the 18 patients were below 15 years of age and 15 were males. Two patients had evidence of intracranial trauma on computed tomography (CT). The outcome was favorable in all patients. In view of the extremely low yield of skull x-rays for trauma, we believe that this examination is no longer indicated as a routine procedure. Patients with a suspected intracranial injury should be evaluated by CT study.