[Brain concussion: risk factors].
OBJECTIVE
Identification of risk factors for intracranial bleeding after minor traumatic brain injury.


METHODS
The charts of 464 patients treated between January 1976 and December 1997 with the initial diagnosis of minor traumatic brain injury were reviewed. They were analyzed for clinical and diagnostic signs putting the patients at risk for intracranial bleeding.


RESULTS
About two thirds of the patients (67.5%) were males, the average age being 36.1 years. Leading causes of accident were sudden falls (27.4%) and bike/autocycle crashes (24.8%). 30.4% of the patients were under the influence of alcohol. At the time of admission to the hospital 17.2% of the patients showed impaired consciousness and 12.5% presented neurologic signs. In ten patients an intracranial bleeding was found. All these bleedings were diagnosed at the primary investigation.


CONCLUSIONS
Following groups of patients with traumatic brain injury have an increased risk for intracranial bleeding: Age > 60 and < 16 years, sudden falls, tachycardia, Glasgow-Coma-Scale < 15, impairment of consciousness, neurologic signs, fracture of the skull and patients suffering from coagulopathy. Drunk patients are difficult to judge; therefore, they should be handled as being at risk. Patients at increased risk should be observed on an intensive care unit whereas patients without those risk factors can be observed on a normal ward or, alternatively, discharged after reexamination and uneventful course after some hours.
Baumgartner
U
U
Abteilung Allgemein- und Viszeralchirurgie, Chirurgische Universitätsklinik Freiburg.
Baier
P K
PK
Schmitz
D T
DT
Farthmann
E H
EH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000435:Alcoholic Intoxication / Q000150:complications; D001924:Brain Concussion / Q000150:complications* / Q000209:etiology; D020202:Cerebral Hemorrhage, Traumatic / Q000209:etiology*; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012307:Risk Factors