Related Experiment Videos
The significance of Babinski signs in children with head trauma
Insights
The Babinski sign in children with head trauma is not a reliable indicator of poor neurological outcome. Asymptomatic children with only Babinski signs can be safely observed at home.
Area of Science:
- Pediatric Neurology
- Trauma Care
Background:
- The Babinski sign, an indicator of upper motor neuron lesions, is commonly assessed in pediatric head trauma evaluations.
- Its clinical significance as an isolated finding in children with mild head injuries requires clarification.
Purpose of the Study:
- To investigate the prognostic value of the Babinski sign in children following head trauma.
- To determine if the isolated presence of Babinski signs warrants hospital admission.
Main Methods:
- A prospective study involving 38 children aged 1-15 years with head trauma.
- Patients were categorized based on hospital admission and clinical findings, including the Babinski sign.
- Neurological status was monitored during observation and follow-up.
Main Results:
- Eighteen children presented with Babinski signs as their sole neurological finding.
- All 18 children demonstrated downgoing toes within 12 hours of admission, with persistent Babinski signs.
- The isolated presence of Babinski signs did not correlate with adverse neurological outcomes.
Conclusions:
- The isolated Babinski sign in children with head injury is not predictive of a poor neurological outcome.
- Asymptomatic children with head trauma and only Babinski signs can be safely managed with outpatient observation.
Abstract:
A prospective study was undertaken to investigate the significance of Babinski signs in children with head trauma. Thirty-eight children between the ages of 1 and 15 were studied. Twenty-four of the children were admitted to the hospital for observation; 14 were sent home, with 24-hour follow-up in the pediatrics clinic. Of the 24 children admitted, six were believed to have altered CNS status or other focal findings on examination in the emergency department, and 18 were judged by two independent observers to have Babinski signs, either unilateral or bilateral, as their only neurological finding. Twelve hours after admission, all 18 children who had been admitted on the basis of Babinski signs alone had downgoing toes and they continued to have Babinski signs. The isolated presence of Babinski signs in a child with a history of head injury is not indicative of poor neurological outcome. An otherwise asymptomatic child who presents with a history of head injury and a solitary finding of Babinski sign(s) may be observed safely at home rather than being admitted to the hospital for observation.