Relative risk of deterioration after mild closed head injury.
In this prospective study, a series of 1812 consecutive mild head injured adult patients who visited the hospital emergency department were assessed. Twenty-eight patients (1.5%) deteriorated after head injury; 23 of these (1.3% of the series) required surgical intervention. Five patients (0.3%) deteriorated due to non-surgical causes [post-traumatic seizure 2, syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 3]. Most of the deterioration occurred within the first 24 hours (57%). Post-traumatic headache was found in 280 patients (15.5%) and 84 patients (4.6%) suffered post-traumatic vomiting. The relative risk is calculated. Age over 60, presence of drowsiness, focal motor weakness, post-traumatic headache and vomiting has increased risk of deterioration (p < 0.001). This study suggests that post-traumatic headache and vomiting deserve more clinical attention rather than being considered as post-traumatic syndrome only.
Lee
S T
ST
Department of Neurosurgery, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
Liu
T N
TN
Wong
C W
CW
Yeh
Y S
YS
Tzaan
W C
WC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D004834:Epilepsy, Post-Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006261:Headache / Q000209:etiology; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012306:Risk; D014839:Vomiting / Q000209:etiology