Necessity of repeat head computed tomography after isolated skull fracture in the pediatric population
Abstract Background Head injuries are common in the pediatric population, but when an isolated skull fracture is found, there are no guidelines for repeat imaging. This study evaluated the need for repeat head computed tomography (CT) for isolated skull fracture. Methods A 10-year retrospective revi...
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| Veröffentlicht in: | The American journal of surgery 2015-08, Vol.210 (2), p.322-325 |
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| creator | Hentzen, Andrew S., M.D Helmer, Stephen D., Ph.D Nold, R. Joseph, M.D Grundmeyer, Raymond W., M.D Haan, James M., M.D |
| description | Abstract Background Head injuries are common in the pediatric population, but when an isolated skull fracture is found, there are no guidelines for repeat imaging. This study evaluated the need for repeat head computed tomography (CT) for isolated skull fracture. Methods A 10-year retrospective review was conducted of patients 17 years and younger with isolated skull fractures. Data included demographics, injury severity score (ISS), fracture location, clinical indicators of head trauma, intracranial hemorrhage, and mortality. Results Of the 65 patients in this study, mean age was 4.2 years, ISS was 7.2, and head/neck abbreviated injury score was 2.3. Most injuries were from falls (69.2%) and motor vehicle collisions (23.1%). The most common clinical indicators associated with skull fractures were nonfrontal scalp hematoma (40.0%), severe mechanism (30.8%), and loss of consciousness (30.8%). One patient who developed intracranial hemorrhage after the initial head CT showed no bleed. There were no deaths. Conclusion Isolated skull fractures in the pediatric population do not necessitate a repeat head CT as long as they do not develop worsening clinical indicators of head injury. |
| doi_str_mv | 10.1016/j.amjsurg.2014.11.011 |
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Joseph, M.D ; Grundmeyer, Raymond W., M.D ; Haan, James M., M.D</creator><creatorcontrib>Hentzen, Andrew S., M.D ; Helmer, Stephen D., Ph.D ; Nold, R. Joseph, M.D ; Grundmeyer, Raymond W., M.D ; Haan, James M., M.D</creatorcontrib><description>Abstract Background Head injuries are common in the pediatric population, but when an isolated skull fracture is found, there are no guidelines for repeat imaging. This study evaluated the need for repeat head computed tomography (CT) for isolated skull fracture. Methods A 10-year retrospective review was conducted of patients 17 years and younger with isolated skull fractures. Data included demographics, injury severity score (ISS), fracture location, clinical indicators of head trauma, intracranial hemorrhage, and mortality. Results Of the 65 patients in this study, mean age was 4.2 years, ISS was 7.2, and head/neck abbreviated injury score was 2.3. Most injuries were from falls (69.2%) and motor vehicle collisions (23.1%). The most common clinical indicators associated with skull fractures were nonfrontal scalp hematoma (40.0%), severe mechanism (30.8%), and loss of consciousness (30.8%). One patient who developed intracranial hemorrhage after the initial head CT showed no bleed. There were no deaths. Conclusion Isolated skull fractures in the pediatric population do not necessitate a repeat head CT as long as they do not develop worsening clinical indicators of head injury.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2014.11.011</identifier><identifier>PMID: 25907850</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Age ; All terrain vehicles ; Blood pressure ; Child ; Child, Preschool ; Coma ; Computed tomography ; Consciousness ; Female ; Fractures ; Head injuries ; Hemorrhage ; Hospitalization ; Humans ; Infant ; Intensive care ; Male ; Medical imaging ; Mortality ; Pediatric ; Pediatrics ; Population ; Retrospective Studies ; Skull fracture ; Skull Fractures - diagnostic imaging ; Studies ; Surgery ; Tomography, X-Ray Computed - methods ; Trauma ; Ventilation</subject><ispartof>The American journal of surgery, 2015-08, Vol.210 (2), p.322-325</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Aug 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c551t-69c56421485bd700ebbad8bf617cb0e5a08797fbc3e4f3e16d399ebe901e8b033</citedby><cites>FETCH-LOGICAL-c551t-69c56421485bd700ebbad8bf617cb0e5a08797fbc3e4f3e16d399ebe901e8b033</cites><orcidid>0000-0002-8760-7950</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961015001221$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25907850$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hentzen, Andrew S., M.D</creatorcontrib><creatorcontrib>Helmer, Stephen D., Ph.D</creatorcontrib><creatorcontrib>Nold, R. Joseph, M.D</creatorcontrib><creatorcontrib>Grundmeyer, Raymond W., M.D</creatorcontrib><creatorcontrib>Haan, James M., M.D</creatorcontrib><title>Necessity of repeat head computed tomography after isolated skull fracture in the pediatric population</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Head injuries are common in the pediatric population, but when an isolated skull fracture is found, there are no guidelines for repeat imaging. This study evaluated the need for repeat head computed tomography (CT) for isolated skull fracture. Methods A 10-year retrospective review was conducted of patients 17 years and younger with isolated skull fractures. Data included demographics, injury severity score (ISS), fracture location, clinical indicators of head trauma, intracranial hemorrhage, and mortality. Results Of the 65 patients in this study, mean age was 4.2 years, ISS was 7.2, and head/neck abbreviated injury score was 2.3. Most injuries were from falls (69.2%) and motor vehicle collisions (23.1%). The most common clinical indicators associated with skull fractures were nonfrontal scalp hematoma (40.0%), severe mechanism (30.8%), and loss of consciousness (30.8%). One patient who developed intracranial hemorrhage after the initial head CT showed no bleed. There were no deaths. Conclusion Isolated skull fractures in the pediatric population do not necessitate a repeat head CT as long as they do not develop worsening clinical indicators of head injury.</description><subject>Adolescent</subject><subject>Age</subject><subject>All terrain vehicles</subject><subject>Blood pressure</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Coma</subject><subject>Computed tomography</subject><subject>Consciousness</subject><subject>Female</subject><subject>Fractures</subject><subject>Head injuries</subject><subject>Hemorrhage</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Infant</subject><subject>Intensive care</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Mortality</subject><subject>Pediatric</subject><subject>Pediatrics</subject><subject>Population</subject><subject>Retrospective Studies</subject><subject>Skull fracture</subject><subject>Skull Fractures - diagnostic imaging</subject><subject>Studies</subject><subject>Surgery</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Trauma</subject><subject>Ventilation</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk-L1TAUxYsoznP0IygBN25a702bttkow-A_GHShrkOa3s7Lm7apSSq8b2_KeyrMZlYh5HdPOOfcLHuJUCBg_fZQ6OkQVn9bcMCqQCwA8VG2w7aRObZt-TjbAQDPZY1wkT0L4ZCuiFX5NLvgQkLTCthlw1cyFIKNR-YG5mkhHdmedM-Mm5Y1Us-im9yt18v-yPQQyTMb3Ki3l3C3jiMbvDZx9cTszOKe2EK91dFbwxa3rIm0bn6ePRn0GOjF-bzMfn788OP6c37z7dOX66ub3AiBMa-lEXXFsWpF1zcA1HW6b7uhxsZ0QEJDctcMnSmpGkrCui-lpI4kILUdlOVl9uaku3j3a6UQ1WSDoXHUM7k1KGxSWC0XJX8YrSVwBFFtqq_voQe3-jkZSVQry4pLCYkSJ8p4F4KnQS3eTtofFYLaOlMHde5MbZ0pRJUKSXOvzuprN1H_b-pvSQl4fwIoJffbklfBWJpNytmTiap39sEv3t1TMKOdrdHjHR0p_HejAlegvm-Ls-0NirQynGP5Bwbqv-g</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Hentzen, Andrew S., M.D</creator><creator>Helmer, Stephen D., Ph.D</creator><creator>Nold, R. Joseph, M.D</creator><creator>Grundmeyer, Raymond W., M.D</creator><creator>Haan, James M., M.D</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8760-7950</orcidid></search><sort><creationdate>20150801</creationdate><title>Necessity of repeat head computed tomography after isolated skull fracture in the pediatric population</title><author>Hentzen, Andrew S., M.D ; Helmer, Stephen D., Ph.D ; Nold, R. Joseph, M.D ; Grundmeyer, Raymond W., M.D ; Haan, James M., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c551t-69c56421485bd700ebbad8bf617cb0e5a08797fbc3e4f3e16d399ebe901e8b033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Age</topic><topic>All terrain vehicles</topic><topic>Blood pressure</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Coma</topic><topic>Computed tomography</topic><topic>Consciousness</topic><topic>Female</topic><topic>Fractures</topic><topic>Head injuries</topic><topic>Hemorrhage</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Infant</topic><topic>Intensive care</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Mortality</topic><topic>Pediatric</topic><topic>Pediatrics</topic><topic>Population</topic><topic>Retrospective Studies</topic><topic>Skull fracture</topic><topic>Skull Fractures - diagnostic imaging</topic><topic>Studies</topic><topic>Surgery</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Trauma</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hentzen, Andrew S., M.D</creatorcontrib><creatorcontrib>Helmer, Stephen D., Ph.D</creatorcontrib><creatorcontrib>Nold, R. Joseph, M.D</creatorcontrib><creatorcontrib>Grundmeyer, Raymond W., M.D</creatorcontrib><creatorcontrib>Haan, James M., M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hentzen, Andrew S., M.D</au><au>Helmer, Stephen D., Ph.D</au><au>Nold, R. Joseph, M.D</au><au>Grundmeyer, Raymond W., M.D</au><au>Haan, James M., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Necessity of repeat head computed tomography after isolated skull fracture in the pediatric population</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2015-08-01</date><risdate>2015</risdate><volume>210</volume><issue>2</issue><spage>322</spage><epage>325</epage><pages>322-325</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Abstract Background Head injuries are common in the pediatric population, but when an isolated skull fracture is found, there are no guidelines for repeat imaging. This study evaluated the need for repeat head computed tomography (CT) for isolated skull fracture. Methods A 10-year retrospective review was conducted of patients 17 years and younger with isolated skull fractures. Data included demographics, injury severity score (ISS), fracture location, clinical indicators of head trauma, intracranial hemorrhage, and mortality. Results Of the 65 patients in this study, mean age was 4.2 years, ISS was 7.2, and head/neck abbreviated injury score was 2.3. Most injuries were from falls (69.2%) and motor vehicle collisions (23.1%). The most common clinical indicators associated with skull fractures were nonfrontal scalp hematoma (40.0%), severe mechanism (30.8%), and loss of consciousness (30.8%). One patient who developed intracranial hemorrhage after the initial head CT showed no bleed. There were no deaths. Conclusion Isolated skull fractures in the pediatric population do not necessitate a repeat head CT as long as they do not develop worsening clinical indicators of head injury.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25907850</pmid><doi>10.1016/j.amjsurg.2014.11.011</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0002-8760-7950</orcidid></addata></record> |
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| subjects | Adolescent Age All terrain vehicles Blood pressure Child Child, Preschool Coma Computed tomography Consciousness Female Fractures Head injuries Hemorrhage Hospitalization Humans Infant Intensive care Male Medical imaging Mortality Pediatric Pediatrics Population Retrospective Studies Skull fracture Skull Fractures - diagnostic imaging Studies Surgery Tomography, X-Ray Computed - methods Trauma Ventilation |
| title | Necessity of repeat head computed tomography after isolated skull fracture in the pediatric population |
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