Association between linear skull fractures and intracranial hemorrhage in children with minor head trauma.
BACKGROUND
To determine whether skull fractures can be used to associate intracranial hemorrhage with minor head trauma (MHT).


OBJECTIVE
We conducted a retrospective study evaluating the association between linear skull fractures and intracranial hemorrhage among children with MHT. Furthermore, we evaluated the significance of small intracranial hemorrhages by assessing the need for neurosurgical interventions.


METHODS
The case group included 114 children with a diagnosis of a linear skull fracture and the control group included 125 children without the diagnosis. We conducted multivariable logistic regression analyses to estimate the odds ratio (OR) between linear skull fractures and intracranial bleeding.


RESULTS
Among the cases, 29 of 114 (25%) children were diagnosed with an intracranial hemorrhage on CT, compared to only 14 of 125 (11%) among the controls. The multivariable OR for intracranial hemorrhages comparing cases and controls adjusted for age and gender was 2.17 (95% confidence interval [CI]: 1.01, 4.68). All the intracranial hemorrhages were small (3.8 +/- 2.3 mm) and none of them required any neurosurgical intervention.


CONCLUSIONS
The presence of a linear skull fracture is an independent risk factor for intracranial hemorrhage. However, all the intracranial hemorrhages associated with the skull fractures were small and did not require any neurosurgical interventions.
Erlichman
David B
DB
Department of Pediatric Radiology, Albert Einstein College of Medicine, Jacobi Medical Center, 1935 Eastchester Rd., #5A, Bronx, NY 10461, USA. derlichman@gmail.com
Blumfield
Einat
E
Rajpathak
Swapnil
S
Weiss
Amanda
A
D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed