Evaluation of minor head injury in children

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Abstract

The authors' goal was to determine criteria for hospitalization for children with minor head injuries. A retrospective review was performed of the hospital records of 401 children with isolated minor head injuries who were admitted to a level I pediatric trauma center between July 1988 and December 1990. Specific information regarding each patient was documented, including demographic data, pertinent physical findings, diagnostic studies, criteria for admission, and hospitalization costs. Fifty-one patients with a mechanism of injury compatible with minor head injury, a brief or no loss of consciousness, a Glasgow coma score of 15, and no abnormalities on radiographic examination did not have neurological complications. The authors believe that these 51 patients could have been discharged from the hospital to responsible parents, thereby decreasing the costs of hospitalization. Prospective studies to substantiate these data and determine which patients should be hospitalized are warranted.

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    Additional imaging can then be performed to assess the extent of intracranial injury. Studies to define better the group of children needing a head CT scan have not been definitive, with even a documented loss of consciousness lacking predictive value [64,65]. The presence of altered mental status, focal neurologic deficit, skull fracture, loss of consciousness, emesis, amnesia, headache, or drowsiness have all been suggested as indications for imaging [51,66].

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Presented at the National Conference on Pediatric Trauma, Indianapolis, Indiana, September 24–26, 1992.

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