[Head injuries in children: can clinical features identify patients with high or low risk for intracranial injury?].
OBJECTIVE
The objective of this study was to assess the clinical features that might reliably identify the presence of an intracranial injury.


METHODS
A prospective study of 1,128 children with head injury over a one year period was carried out. Information regarding each patient was documented, including demographic data, physical examination findings, neurologic status, diagnostic studies and the patient's outcome.


RESULTS
Of the 1.128 patients, traumatic intracranial abnormalities identified on CT of the head was found in 11 (1%). Four patients of this group (36%) required surgery. Two children subsequently died. Loss of consciousness, amnesia. Glasgow Coma Scale less than 15 and focal neurological deficits were significantly more common in the group with intacranial injury. The negative predictive values were high for all features.


CONCLUSIONS
Patients with symptoms of head injury should undergo head CT because a small number will require surgery. After a minor head trauma, children who are neurologically normal and without symptoms may be discharged from the emergency department and sent home after careful physical examination alone.
Benito Fernández
J
J
Departamento de Pediatría, Hospital de Cruces, Baracaldo, Vizcaya.
Mintegui Raso
S
S
Sánchez Echániz
J
J
Martínez González
M J
MJ
Fernández Cuesta
M A
MA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
Traumatismo craneal en la infancia: permite la clínica seleccionar los pacientes en alto o bajo riesgo de presentar una lesión intracraneal?