The value of skull radiography in patients with head trauma

This study assesses the value of skull X-ray after a skull fracture for predicting intracranial hematoma. Patients with a skull injury were divided into three risk groups, based on the history and examination findings. The records of 1218 patients were studied. In the risk group, the existence of a skull fracture and the development of intracranial hematoma were determined. Not a single hematoma was found in the low-risk group. Hence, skull radiography had no significance in this group. In the moderate-risk group two patients had an intracranial hematoma; one patient had a skull fracture. Negative skull radiography therefore did not fully exclude intracranial complications. There were many patients with an intracranial hematoma in the high-risk group, in the presence or not of a skull fracture. CT imaging is the best method for obtaining the diagnosis of intracranial hematoma in this group. In conclusion, plain skull X-rays are of little value in patients with acute head trauma.