Citation

Ohbuchi H, Hagiwara S, Hirota K, Koseki H, Kuroi Y, Arai N, Kasuya H. World Neurosurg. 2016; 98: 479-483.

Affiliation

Department of Neurosurgery, Tokyo Women's Medical University Medical Center East.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.wneu.2016.11.045

PMID

27876657

Abstract

OBJECTIVE: Minor head trauma is common in children. Though most cases are nonsignificant, minor head trauma can lead to the deterioration of intracranial injuries, which is preventable. The aim of this study was to identify clinical predictors of intracranial injuries in infants with minor head trauma.

METHODS: We retrospectively enrolled infants under 11 months with minor head trauma between 2006 and 2013. The following data were recorded: age, sex, cause of trauma, fall height, vomiting, bad temper, size and location of scalp hematoma, fracture, and intracranial injuries on CT.

RESULTS: Of the 549 enrolled infants, fifteen (3%) had suffered traumatic intracranial injuries: epidural hematoma in 7, subarachnoid hemorrhage in 4, subdural hematoma in 3, and cerebral contusion in one. Intracranial injuries were found in 8 of 98 infants who had fallen from a >60 cm height, one in 197 >30 cm, none in 44 <30 cm (p=0.0001); one of 2 scalp hematomas > 6 cm, 10 of 35 >3 cm, 2 of 121 <3 cm (p=0.0001); 9 of 28 with temporal hematoma, 2 of 15 parietal, 2 of 22 occipital, none of 98 frontal (p=0.0001). Logistic regression analysis showed that scalp hematoma was related to intracranial injuries (HR=21.127, p=0.0001) whereas the age, sex, fall, vomiting, and bad temper were not.

CONCLUSION: The fall height and size and location of the scalp hematoma were associated with intracranial injuries. Based on these results, we should take these factors into consideration when making decisions on radiological examinations of infants with minor head trauma.

Copyright © 2016. Published by Elsevier Inc.

Language: en