[Is skull radiography indicated in patients with head injuries?].
The value of the radiographic finding of a skull fracture in predicting intracranial haematoma is assessed in this study. Patients with a skull injury can be divided into three risk groups, based on the history and examination findings. The low-risk group includes patients who are asymptomatic or have scalp haematoma, lacerations, headache or dizziness. The moderate-risk group includes patients who have posttraumatic amnesia and/or alcohol intoxication and those who are suspected of having a skull fracture. The patients in the high-risk group have clear symptoms and signs such as depressed level of consciousness or focal neurological signs. The records of 1218 patients were studied. The risk group, the existence of a skull fracture and development of intracranial haematoma were determined. Not a single haematoma was found in the low-risk group. Therefore skull radiography had no significance in this group. In the moderate-risk group two patients had an intracranial haematoma, of whom one patient had a skull fracture. Negative skull radiography therefore did not fully exclude intracranial complications. There were many patients with an intracranial haematoma in the high-risk group, both in the presence and the absence of a skull fracture. CT scanning is the best method of detecting an intracranial haematoma in this group.
Pasman
P
P
Vakgroep Epidemiologie en Biostatistiek, Rijksuniversiteit Limburg, faculteit Geneeskunde, Maastricht.
Twijnstra
A
A
Wilmink
J
J
Leffers
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging*; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012886:Skull / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
Is een röntgenfoto van de schedel geïndiceerd bij patiënten met trauma capitis?