We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Trial of life: Well infants presenting more than 24 h after head injury with a scalp haematoma: A 10-year review.
- Authors
Parameswaran, Ahilan; Heitner, Shmuel; Thosar, Deepali; Fowler, Adam; Marks, Susan; O'Leary, Fenton
- Abstract
<bold>Aim: </bold>To review the investigation, patterns of injury and short-term outcomes of infants younger than 12 months of age who presented more than 24 h after head injury with an isolated scalp haematoma.<bold>Methods: </bold>A retrospective chart review of infants who presented with a head injury to the emergency department of a major paediatric hospital between 2006 and 2016. Patients were included if they presented more than 24 h after the injury, were clinically well and had a documented scalp haematoma. Charts were abstracted using a standardised instrument to yield patient characteristics, mechanism of injury, imaging performed, identified injuries and patient outcome.<bold>Results: </bold>A total of 2433 records were reviewed, with 157 included in the study. The mean age was 7.5 months (standard deviation 2.6). Of the patients, 14 had a documented palpable skull fracture; 43 patients had a skull X-ray reported as a fracture; 13 patients had cranial ultrasounds with 3 reported as having a fracture; 124 patients had computed tomography head imaging, with 112 demonstrating a fracture; and 52 patients had acute intracranial abnormalities. There were nine unplanned representations (5.7%). No patients required any neurosurgical intervention.<bold>Conclusions: </bold>Infants presenting after 24 h with isolated scalp haematomas had good short-term outcomes despite a high prevalence of underlying injury on imaging. Expectant management, rather than imaging, may be a valid approach in this patient population. However, some of these injuries may have been the result of inflicted injury, and all of these patients require a robust assessment regardless of the decision to use a computed tomography scan.
- Subjects
INFANTS' injuries; HEALTH outcome assessment; HEAD injuries; HEMATOMA; EMERGENCY medicine; HEAD injury complications; AUDITING; PEDIATRICS; SCALP; RETROSPECTIVE studies
- Publication
Journal of Paediatrics & Child Health, 2018, Vol 54, Issue 11, p1193
- ISSN
1034-4810
- Publication type
journal article
- DOI
10.1111/jpc.13932