[Minor head injuries. Prognostic factors in the evaluation of patients]

In order to identify signs to be used in the decision whether or not to admit patients after minor head injuries (MHI), the records of 713 females and 1163 males were reviewed. Skull X-ray was not obtained routinely, all patients were able to talk and walk when they reached medical contact. Nine patients developed an intracranial complication, three had an operation and one died. The risk of developing an ICC was 16.7% when the patient was agitated, 3.4% in the presence of impaired consciousness and 2.1% when positive neurological signs were observed at the time of examination. Based on the medical history, amnesia for more than five minutes and vomiting were associated with a risk of 3.3% and 1.2% respectively. The risk increased considerably in the presence of two of the above mentioned signs and was 60% if the patient was agitated and had amnesia for more than five minutes. Consequently, we recommend that all patients with one or more of the above symptoms or alcohol intoxication after a MHI should be admitted for observation. This policy may hold the possibility of considerable economic savings.