[Who should be hospitalized following mild craniocerebral trauma?].
The frequency of minor closed head injuries is high. These injuries may be complicated by the development of life-threatening intracranial hematomas. A well-defined selection criteria for admission must be proposed to guarantee an efficacious observation. In our series of 489 hospitalized patients with a GCS of 15 when seen in the emergency room: 4 patients required evacuation of an intracranial hematoma, 11 revision of a depressed skull fracture or a compound fracture of base of the anterior fossa. Using the existence of a skull fracture as a selection for admission, a strategy proposed by Jennett and colleagues, it would have been possible to reduce the number of patients hospitalized by 70% without missing a patient who developed an intracranial hematoma. Following these criteria no intracranial hematoma would be missed in our patients with a GCS of 15. We suggest that the use of plain x-rays to identify skull fractures and subsequent hospitalization prevents missing an intracranial hematoma. Those patients with diminished levels of consciousness of focal neurologic deficits require admission irrespective of skull fractures.
Imhof
H G
HG
Neurochirurgische Klinik, Universitätsspital Zürich.
Dolder
E
E
Käch
K
K
Künzi
W
W
Platz
A
A
Rüttner
B
B
Vollenweider
A
A
D000328:Adult; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000601:surgery; D004630:Emergencies; D005260:Female; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000175:diagnosis / Q000601:surgery*; D006760:Hospitalization; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012887:Skull Fractures / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed
Wer soll nach einem leichten Schädel-Trauma hospitalisiert werden?