The significance of skull fracture in mild head trauma differs between children and adults.
OBJECTIVE
The objective was to determine whether the age of patients with mild head injury and skull fracture influences the level of risk for acute intracranial injuries.


METHODS
A study was conducted of 156 patients with skull fracture, 60 children (aged <14 years) and 96 adults, detected among 5,097 consecutive patients with mild head injury (Glasgow Coma Scale [GCS] score of 15-14 points) arriving at the Emergency Department of a Level I University Hospital Trauma Center during 1998. Acute intracranial injuries were defined as traumatic brain injuries identified by cranial computed tomography scan, excluding pneumocephalus.


RESULTS
Compared with the children, this risk of intracranial injury was 13 times greater in the adults aged 14-54 years and 16 times greater in the over-54-year-olds. Besides age over 14 years (p<0.0001), compound skull fracture (p<0.001), and a GCS score of 14 (p<0.001) were factors significantly associated with intracranial injury in the logistic regression analysis.


CONCLUSIONS
Skull fracture in mild head injury implies a greater risk of intracranial injury in adults than in children.
Muñoz-Sánchez
M A
MA
Department of Critical Care and Emergency, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013, Sevilla, Spain. angeles.munoz.sspa@juntadeandalucia.es
Murillo-Cabezas
F
F
Cayuela
A
A
Flores-Cordero
J M
JM
Rincón-Ferrari
M D
MD
Amaya-Villar
R
R
Fornelino
A
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000473:pathology*; D005260:Female; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012189:Retrospective Studies; D012307:Risk Factors; D012887:Skull Fractures / Q000209:etiology* / Q000473:pathology*; D014057:Tomography, X-Ray Computed