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The Relationship Between Type and Size of Scalp Injury and Intracranial Injury Among Patients who Visited the Emergency room due to head Trauma  

Kim, Yong Sung (Department of Emergency Medicine, Soon Chun Hyang University College of Medicine)
Lim, Hoon (Department of Emergency Medicine, Soon Chun Hyang University College of Medicine)
Cho, Young Soon (Department of Emergency Medicine, Soon Chun Hyang University College of Medicine)
Kim, Ho Jung (Department of Emergency Medicine, Soon Chun Hyang University College of Medicine)
Publication Information
Journal of Trauma and Injury / v.19, no.1, 2006 , pp. 8-13 More about this Journal
Abstract
Purpose: Traumatic head injury is very common in the emergency room. Early diagnosis and treatment can significantly reduce mortality and morbidity. When diagnosis is delayed, however, it could be critical to the patients. In reality, it is difficult to take a brain CT for all patients with head trauma, so this study examined the relationship between type and size of scalp injury and intracranial injury. Methods: This prospective study was conducted from May 2005 to July 2005. The participants were 193 patients who had had a brain CT. Head trauma included obvious external injury or was based on reports of witnesses to the accident. Children under three years of age were also included if there was a witness to the accident. The size of the injury was measured based on the maximum diameter. Results: Out of the total of 193 patients, patients with scalp bleeding totaled 126 (65.2%), and patients without scalp bleeding totaled 67 (34.8%). Among patients with scalp bleeding, patients with intracranial injuries numbered nine, and among patients without scalp bleeding, patients with intracranial injuries numbered 17 (P=0.001). Among patients who showed evidence of scalp swelling with no scalp bleeding, the relationship between the size of the scalp swelling and intracranial injury was statistically significant when the size of the scalp swelling was between 2 cm and 5 cm. Conclusion: Among patients who visit an emergency medical center due to traumatic head injury, patients with no scalp bleeding, but with scalp swelling between 2 cm and 5 cm, should undergone more accurate and careful examination, as well as as a brain CT.
Keywords
Brain injury; Traumatic intracranial hemorrhage;
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1 Kim KH, Lee KH, Kim WY, Yoon YC, Kim HY. Computed tomography in head trauma patients with alert mental status: how important are the clinical symptoms. J Korean Soc Emerg Med 1996;8:564-70
2 Greenes DS, Schutzman SA. Infants with isolated skull fracutre:what are their clinical characteristics, and do they require hospitalization? Ann Emerg Med 1997;30:253-9   DOI   ScienceOn
3 Greenes DS, Schutzman SA. Clinical indicators intracranial injury in head injuried infants. Pediatrics 1999;104:861-7   DOI   ScienceOn
4 Quayle KS, Jaffe DM, Kuppermann N, Kaufman BA, Lee BCP, Park TS et al. Diagnosistic testing for acute head injury in children. Pediatrics 1997;99:11-8
5 Lim YS, Youm SL, Shin JH, Ryoo E, Yang HJ, Park CW et al. Clinical analysis of head trauma in children admitted to department of emergency medicine. J Korean Soc Emerg Med 1996;10:456-65
6 Brown L, Moynihan JA, Denmark TK. Blunt pediatric head trauma requiring neurosurgical intervention. Am J Emerg Med 2003;21:467-72   DOI   ScienceOn
7 Homer CJ, Kleinman L. Technical report: minor head injury in Children. Pediatrics 1999;104:78-84   DOI   ScienceOn
8 Greenes DS, Schutzman SA. Occult intracranial injury in infants. Ann Emerg Med 1998;32:680-6   DOI   ScienceOn
9 Haydel MJ, Shembekar AD. Prediction of intracranial injury in children aged five years and older with loss of consciousness after minor head injury due to nontrivial mechanisms. Ann Emerg Med 2003;42:507-14   DOI   ScienceOn
10 Yang HJ, Park JB, Pyo CH, MD, Park CW, Lee K. Pediatric head injury: the nature, clinical course, and outcome. J Korean Soc Emerg Med 1994;5:209-24
11 Tintinalli JE, Kalen GD, Stapczynski JS. Emergency Medicine. A comprehensive study guide. 6th ed. New York: McGraw-Hill, 2004. p.1557
12 Palchak MJ, Holmes JF, Vance CW, Gelber RE, Schauer BA, Harrison MJ et al. A decision rule for identifying children at low risk for brain injuries after blunt head trauma. Ann Emerg Med 2003;42:492-506   DOI   ScienceOn
13 Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, Deblieux PMC. Indications for computed tomography in patients with minor head injury. N Eng J Med 2000;343:100-5   DOI   ScienceOn
14 Geijerstam JL, Britton M. Reliability of early computed tomographic findings in triage for admission. Emerg Med 2005;22:103-7   DOI   ScienceOn
15 Halley MK, Silva PD, Foley J, Rodarte A. Loss of consciousness: when to perform computed tomography. Pediatr Crit Care Med 2004:5;230-3   DOI   ScienceOn
16 Heo T, Kim SG, Min YI. The value of brain CT scanning for alert patients following mild head injury. J Korean Soc Emerg Med 1997;8:87-92
17 Choi SW, Sohn DK, Lee HS. A high-yield clinical variable for brain CT scan in head injured patients. J Korean Soc Emerg Med 1994;5:202-8
18 Chung HS, Park CW, Lee K. A clinical analysis on the management of moderate head injury. J Korean Soc Emerg Med 1993;4:63-72
19 Park JB, Park CW, Lee K. The value of computed tomographic scans for patients with low-risk head injuries. J Korean Soc Emerg Med 1994;5:5-16
20 Sifri ZC, Livingston DH, Lavery RF, Homnick AT, Mosenthal AC, Mohr AM. Value of repeat cranial computed axial tomography scanning in patients with minimal head injury. Am J Surg 2004;187:338-42   DOI