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J Korean Soc Emerg Med > Volume 15(6); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(6): 588-593.
Minor Head Trauma in Children Younger than 2 Years of Age
Jong Oh Kim, Kyung Hwan Kim, Sung Eun Kim
Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Koyang, Kyeonggi-do, Korea. khkim@ilsanpaik.ac.kr
ABSTRACT
PURPOSE:
The subjects of this study were minor head trauma patients under the age of two, this analyzing skull fracture (SF) and traumatic brain injury (TBI) were analyzed for the purpose of providing basic data for controlling the use of plain skull X-rays and Brain CTs and for selecting on approaches to treatment.
METHODS:
We performed a 2-year retrospective review, and data were collected on historical features, physical findings, radiological findings, and hospital course.
RESULTS:
Of 110 study subjects, 15 (13.6%) patients had SF/TBI. Falls were the most common cause of head injury (79.1%). 8 (9.2%) patients in falls had SF/TBI. Heights of fall above 1 m were associated with a higher incidence of SF/TBI (p<0.05). Children younger than 12 months had a higher incidence of SF/TBI (46.2% vs 2.7%) than children aged 13 to 24 months (p<0.05). Scalp abnormalities were more common in children with SF/TBI (p<0.05). The incidences of behavioral change, loss of consciousness, emesis, and seizures did not differ significantly between those with normal radiological findings and those with SF/TBI. For Falls from heights less than 1 m, infants older than 12 months with normal scalp findings showed no SF/TBI.
CONCLUSION:
In this study, the plain skull X-ray and Brain CT were shown not to be necessary for infants older than 12 months with normal scalp findings and falls from heights of less than 1 m, provided there were no serious clinical symptoms.
Key words: Minor head injury, Skull fracture, Traumatic brain injury
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