Clinical Predictors of Intracranial Injuries in Infants with Minor Head Trauma

Ohbuchi, Hidenori; Hagiwara, Shinji; Hirota, Kaoru; Koseki, Hirokazu; Kuroi, Yasuhiro; Arai, Naoyuki

doi:10.1016/j.wneu.2016.11.045

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…In accordance with previous investigations, the scalp hematoma and mechanism of injury were independent predictors of intracranial injuries on CT in our study [ 14 , 15 ]. The literature indicates that a severe mechanism independently increases the risk of intracranial injuries, and falls from greater heights increase the prevalence of skull fractures traumatic brain injury [ 16 ], which suggests that clinicians should closely observe children with scalp hematomas after more severe mechanisms of injury in the emergency department.…”

Section: Discussionsupporting

confidence: 93%

Clinical predictors of intracranial injuries on CT in infants younger than 2 years old with mild traumatic brain injury

Liu

et al. 2017

Oncotarget

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PurposeMild traumatic brain injury (TBI) is common in children. The aim of this study was to identify clinical predictors of intracranial injuries on computed tomography (CT) in infants younger than 2 years old with mild TBI, which allow reducing number of imaging.ResultsOf 214 enrolled infants with complete data, 30 (5.8%) sustained intracranial injuries. Younger age in months, severe injury mechanism and scalp hematomas were associated with traumatic intracranial injuries on CT. 71 had scalp hematomas and 143 had no scalp hematoma. Within infants with scalp hematomas, 26 sustained intracranial injuries and 45 presented normal. Intracranial injuries were significantly correlated with larger scalp hematomas and different scalp hematoma locations. Logistic regression analysis showed that scalp hematoma and mechanism of injury in infants younger than 2 years old with mild TBI was related to intracranial injuries (hazard ratio=38.291, P=0.0001; hazard ratio=0.174, P=0.001). In subgroup of mild TBI infants with scalp hematomas, logistic regression analysis showed age, scalp hematoma size and mechanism of injury were independently associated with intracranial injuries (hazard ratio=0.299, P=0.032; hazard ratio=5.272, P=0.006; hazard ratio=0.312, P=0.030).MethodsBetween 2014 and 2016, we retrospectively enrolled infants <2 years old with mild TBI. Data recorded included age, sex, mechanism of head injury, size and location of scalp hematoma, fracture and intracranial injuries on CT.ConclusionThe characteristics of scalp hematomas and mechanism of injury were associated with intracranial injuries. These factors should be considered when making decisions on radiologic examinations of infants < 2 years old with mild TBI and alternative procedures, which do not involve ionizing radiation, should be used if appropriate.

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Section: Discussionsupporting

confidence: 93%

Clinical predictors of intracranial injuries on CT in infants younger than 2 years old with mild traumatic brain injury

Liu

et al. 2017

Oncotarget

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“…Other signs and symptoms may occur concomitantly with vomiting in cases of mild infant TBI such as drowsiness, fainting, and headache, which indicate the need for health care professionals and prevention of possible avoidable complications. [8][9] Among the complications, hematomas and fractures were observed, confirming the relationship between vomiting and fractures, as the existing literature states, coming to the reality presented by Pereira, who states: "The association between cranial fractures and intracranial lesions is not as strong in adults. Studies show that vomiting is not an isolated risk factor for patients suffering from mild TBI".…”

Section: Discussionsupporting

confidence: 53%

“…1 It is explained that childhood mild TBI is recurrent and caused by falls in any environment, the most frequent being domestic and predominant in males, as many authors report in their studies due to motor incoordination or to the practices and attitudes of greater physical activity, often of contact, providing greater risks to the lives of children who, because of their habitat, feel more freedom to explore the area, with less concern and action of their caregivers or parents. 5,[7][8][9] It is understood that vomiting is one of the most important signs and symptoms, as it is evidenced in patients during, before or after the trauma, as described by other epidemiological profile surveys. 9 It is necessary to observe this patient within 24 hours for x-ray examinations or computerized tomography or magnetic resonance imaging, with the purpose of analyzing the skull cap and evidencing some type of fracture to perform possible interventions, however, it is important that health professionals know the correct exams so that there is no unnecessary expense and not expose the child to ionizing radiation and biological risks.…”

Section: Discussionmentioning

confidence: 99%

“…5,[7][8][9] It is understood that vomiting is one of the most important signs and symptoms, as it is evidenced in patients during, before or after the trauma, as described by other epidemiological profile surveys. 9 It is necessary to observe this patient within 24 hours for x-ray examinations or computerized tomography or magnetic resonance imaging, with the purpose of analyzing the skull cap and evidencing some type of fracture to perform possible interventions, however, it is important that health professionals know the correct exams so that there is no unnecessary expense and not expose the child to ionizing radiation and biological risks. 1,10 Vomiting is also important in deciding which examination should be performed on the patient, such as if two or more emetic episodes occur when at least one computed tomography.…”

Section: Discussionmentioning

confidence: 99%

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Perfil epidemiológico do vômito em trauma cranioencefálico leve infantil

Lima

Amorim

Medeiros

et al. 2019

Rev enferm UFPE on line.

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RESUMOObjetivo: analisar o perfil epidemiológico do vômito em caso de Trauma Cranioencefálico leve infantil em um Hospital de Referência. Método: trata-se de estudo quantitativo, descritivo, transversal, com análise documental em prontuários, determinando-se a amostra por conveniência. Dividiram-se, na análise das variáveis, os dados em: 1ª parte voltada aos dados socioeconômicos e a 2ª parte, aos dados do trauma com o vômito, por meio de um questionário. Armazenaram-se e analisaram-se os dados com o auxílio do software Microsoft Excel 2013, e se apresentaram em forma de tabelas. Resultados: obteve-se o total de 121 pacientes, com prevalência masculina, de um ano de idade e com queda. Encontrou-se o total de 379 vômitos, apresentando um vômito, no mínimo. Informa-se que não foram utilizados antieméticos em 83,47% dos casos. Conclusão: constataram-se a falta de administração de antieméticos e a escassez de estudos sobre vômito como sintoma principal do TCE leve infantil, proporcionando novas pesquisas. Descritores: Traumatismos Craniocerebrais; Vômito; Pré-Escolar; Cuidado da Criança; Perfil de Saúde; Antieméticos.ABSTRACTObjective: to analyze the epidemiological profile of vomiting in case of mild Cranioencephalic Infant Trauma in a Reference Hospital. Method: this is a quantitative, descriptive, cross-sectional study with documentary analysis in medical records, determining the sample for convenience. In the analysis of the variables, the data were divided into: 1st part focused on the socioeconomic data and the 2nd part, on the data of the trauma with the vomit, through a questionnaire. The data was stored and analyzed using Microsoft Excel 2013 software, and presented in the form of tables. Results: a total of 121 patients, with male prevalence, one year old and with fall were obtained. A total of 379 vomiting were found, with at least one vomit. It is reported that no antiemetics were used in 83.47% of the cases. Conclusion: there was a lack of administration of antiemetics and a lack of studies on vomiting as the main symptom of mild childhood TBI, providing new research. Descriptors: Head and Brain Injuries; Vomiting; Preschool; Child Care; Health Profile; Antiemetics.RESUMEN Objetivo: analizar el perfil epidemiológico del vómito en caso de Trauma Craneoencefálico leve infantil en un Hospital de Referencia. Método: se trata de un estudio cuantitativo, descriptivo, transversal, con análisis documental en prontuarios, determinándose la muestra por conveniencia. Se dividieron en el análisis de las variables los datos en: 1ª parte dirigida a los datos socioeconómicos y la segunda parte, a los datos del trauma con el vómito, por medio de un cuestionario. Se almacenaron y analizaron los datos con la ayuda del software Microsoft Excel 2013, y se presentaron en forma de tablas. Resultados: se obtuvo el total de 121 pacientes, con prevalencia masculina, de un año de edad y con caída. Se encontró el total de 379 vómitos, presentando un vómito, como mínimo. Se informa que no se utilizaron antieméticos en el 83,47% de los casos. Conclusión: se constató la falta de administración de antieméticos y la escasez de estudios sobre vómito como síntoma principal del TCE leve þ, proporcionando nuevas investigaciones. Descriptores: Traumatismos Craneocerebrales; Vómitos; Preescolar; Cuidado del Niño; Perfil de Salud; Antieméticos.

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“…1 Minor head trauma is defined as a patient having a normal mental status at the initial assessment, no abnormal or focal findings on neurological examination, and no physical evidence of skull fracture. 2 For all types of head trauma, morbidity and mortality due to intracranial injury might be prevented by early diagnosis and treatment. 3 Most patients with minor head trauma can be discharged without sequelae after observation in the emergency department (ED).…”

Section: Introductionmentioning

confidence: 99%

Pediatric Minor Head Trauma: Factors Affecting the Anxiety of Parents

Aldinc

Gun

Yaylacı

et al. 2021

Clin Pediatr (Phila)

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Managing the anxiety of the parents of pediatric patients with head trauma is challenging. This study aimed to examine the factors that affect anxiety levels of parents whose children were admitted to the emergency department with minor head trauma. In this prospective study, the parents of 663 consecutive pediatric patients were invited to answer a questionnaire. Parents of 600 children participated in the study. The parents who believed they were provided sufficient information and who were satisfied with the service received had significantly more improvement in anxiety-related questions. Cranial X-ray assessment had a significantly positive impact on the anxiety of the parents, whereas cranial computed tomography and neurosurgery consultation did not. In assessing pediatric minor head trauma, cranial computed tomography imaging and neurosurgery consultation should not be expected to relieve the anxiety of the parents. However, adequately informing them and providing satisfaction are the factors that could lead to improvement.

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Clinical Predictors of Intracranial Injuries in Infants with Minor Head Trauma

Cited by 9 publications

References 13 publications

Clinical predictors of intracranial injuries on CT in infants younger than 2 years old with mild traumatic brain injury

Clinical predictors of intracranial injuries on CT in infants younger than 2 years old with mild traumatic brain injury

Perfil epidemiológico do vômito em trauma cranioencefálico leve infantil

Pediatric Minor Head Trauma: Factors Affecting the Anxiety of Parents

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