Is a skull X-ray necessary after milder head trauma?
During the 2-year period 1985-86 a total of 1,876 patients were admitted to our hospital after milder head trauma including cerebral concussion. Two hundred and eighty four patients who had a skull X-ray were not selected from guidelines. In 1,592 patients without a skull X-ray, signs of an intracranial complication developed in six cases and were verified by CT. In the 284 patients with skull X-ray a fracture was demonstrated in 25, and of these 25 patients only one patient disclosed a cerebral contusion. In the 259 patients with skull X-ray, but without demonstration of fracture, there were subsequently seen one subdural haematoma and one cerebral contusion. The incidence of intracranial complications in patients without and with skull X-ray with or without fracture does not differ significantly. In these circumstances we do not find any justification for routine skull X-ray after milder head trauma.
Rosenørn
J
J
University Clinic of Neurosurgery, Copenhagen County Hospital, Glostrup, Denmark.
Duus
B
B
Nielsen
K
K
Kruse
K
K
Boesen
T
T
D001924:Brain Concussion / Q000000981:diagnostic imaging / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D003718:Denmark; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data*; D005069:Evaluation Studies as Topic; D006801:Humans; D011859:Radiography; D012306:Risk; D012886:Skull / Q000000981:diagnostic imaging*; D012887:Skull Fractures / Q000150:complications / Q000000981:diagnostic imaging