title: Clinical Predictors of Intracranial Injuries in Infants with Minor Head Trauma.
abstract: OBJECTIVE
  Minor head trauma is common in children. Although most cases are nonsignificant, minor head trauma can lead to preventable intracranial injuries. The aim of this study was to identify clinical predictors of intracranial injuries in infants with minor head trauma.
  
  
  METHODS
  Between 2006 and 2013, we retrospectively enrolled infants <11 months old with minor head trauma. Data recorded included age, sex, cause of trauma, fall height, vomiting, bad temper, size and location of scalp hematoma, fracture, and intracranial injuries on computed tomography.
  
  
  RESULTS
  Of 549 enrolled infants, 15 (3%) sustained traumatic intracranial injuries: epidural hematoma in 7, subarachnoid hemorrhage in 4, subdural hematoma in 3, and cerebral contusion in 1. Intracranial injuries were found in 8 of 98 infants who had fallen from a >60 cm height, 1 in 197 with fall height >30 cm, and none in 44 with fall height ≤30 cm (P = 0.0001); 1 of 2 with scalp hematomas >6 cm, 10 of 35 with hematomas >3 cm, and 2 of 121 with hematomas ≤3 cm (P = 0.0001); and 9 of 28 with temporal hematoma, 2 of 15 with parietal hematoma, 2 of 22 with occipital hematoma, and none of 98 with frontal hematoma (P = 0.0001). Logistic regression analysis showed that scalp hematoma was related to intracranial injuries (hazard ratio = 21.127, P = 0.0001), whereas age, sex, fall, vomiting, and bad temper were not.
  
  
  CONCLUSIONS
  Fall height and size and location of scalp hematoma were associated with intracranial injuries. These factors should be considered when making decisions on radiologic examinations of infants with minor head trauma.
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan. Electronic address: hide.ohbuchi@gmail.co.jp.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ohbuchi
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Hagiwara
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Hirota
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Koseki
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kuroi
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Arai
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kasuya
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014839:Vomiting / Q000209:etiology; D057832:Watchful Waiting
keywords: Infants; Minor head trauma; Scalp hematomas