The risk of intracranial complications in pediatric head injury. Results of multivariate analysis.
Retrospective analysis of 12,072 pediatric head injury cases admitted to hospital revealed 159 patients with intracranial complications: 132 had intracranial hematoma and 27 had diffuse brain swelling. Multivariate analysis revealed two risk factors that could be recognized easily by primary-care physicians. They were found to be significant in predicting the development of intracranial complications. These risk factors were impairment of consciousness at the time of admission and clinical and/or radiological skull fracture. Analysis revealed that the combination of impaired consciousness and skull fracture carried the highest risk of complication (75%); however, the presence of impaired consciousness alone had an intermediate level of risk (19%). The presence of skull fracture alone carried a small overall risk (2%); however, this was highly dependent on age. The absence of all the risk factors considered carried a negligible risk of intracranial complications, provided proper skull X-rays were taken and correctly interpreted.
Chan
K H
KH
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Yue
C P
CP
Mann
K S
KS
D000293:Adolescent; D001929:Brain Edema / Q000453:epidemiology* / Q000209:etiology; D001930:Brain Injuries / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012887:Skull Fractures / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D014839:Vomiting