Head injuries and skull radiography: clinical factors predicting a fracture

Tunturi, Turkka; Nieminen, R; Pätiälä, H.; Rokkanen, P; Tammilehto, L.; Turunen, Markku; Lehtinen, E; Seppänen, Seppo

doi:10.1016/0020-1383(82)90162-0

Cited by 4 publications

(1 citation statement)

References 8 publications

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“…Thus, there is ample evidence that certain clinical diagnosis of the presence or absence of a skull fracture is impossible in the overwhelming majority of individual A & E attenders with head injury. Nevertheless, various reports, including this one, have shown that certain characteristics are significantly more common among groups of patients with skull fractures on X-ray and have grouped these characteristics together as a high-yield list (Bell & Loop, 1971;Boulis et al, 1978;Cordon, 1981;Cummins et al, 1980;De Campo & Petty, 1980;de Smet et al, 1979;Masters, 1980;Phillips, 1979;Tunturi et al, 1982). These authors then advocate that only those head injury attenders with one or more of the high-yield characteristics should undergo skull X-ray examination, thereby reducing the number of skull X-rays performed.…”

Section: Discussionmentioning

confidence: 99%

The utility of post-traumatic skull X-rays.

Gorman¹

1987

Emergency Medicine Journal

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SUMMARYDuring two 12-month periods, 12 395 accident and emergency department attenders with head injury were collected. Those characteristics which were significantly more common in head-injured patients who had skull fractures on X-ray were identified. These characteristics were: recent alcohol consumption in adults, initial unconsciousness, amnesia of any duration, vomiting, neurological signs, injuries sustained by pedestrians, motorcyclists and cyclists. Such characteristics were then further examined and their power as diagnostic tests for the presence of skull fracture on X-ray was detailed. In individual patients and especially in children, these characteristics were generally of little value in identifying patients with fractures. It was considered that, in the majority of individual patients with head injuries, accurate clinical diagnosis of radiologically apparent fractures was not possible. In view of this and in the light of the known risks in patients with fractures, it was concluded that skull X-rays should continue to be used relatively freely in the management of these patients.

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Section: Discussionmentioning

confidence: 99%

The utility of post-traumatic skull X-rays.

Gorman¹

1987

Emergency Medicine Journal

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The application of clinical guidelines for skull radiography in the accident and emergency department: Theory and practice

Clarke

Adams

1990

Clinical Radiology

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Significance of Shock in Head-iniured Patients with Skull Fracture.

Yanagawa

Sakamoto

Saitoh

et al. 2000

Neurol. Med. Chir.(Tokyo)

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The clinical differences between patients with skull base and convexity fractures were retrospectively investigated in 324 patients, of whom 110 had suffered head injury resulting in skull fracture. These 110 patients were divided into the skull base and convexity groups. There were no significant differences between the groups with respect to sex, age, Glasgow Coma Scales, injury severity scores, pupil abnormalities, and outcomes. Automobile collisions were the most common causes in the skull base group, and falls in the convexity group. Traumatic Coma Data Bank diffuse 1 type injuries were more frequent in the skull base group and evacuated masses were more frequent in the convexity group. Multiple injuries, shock on admission, lower hemoglobin concentrations, and increased transfusion requirements were evident in the skull base group. Controlling for shock, the outcomes in the skull base group were favorable. Convexity fractures were usually associated with isolated severe head injuries and require brain protection therapy. Skull base fractures were caused by a significant force distributed over a large area of the body with a tendency to induce shock, and require a multidisciplinary approach to treatment.

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Head injuries and skull radiography: clinical factors predicting a fracture

Cited by 4 publications

References 8 publications

The utility of post-traumatic skull X-rays.

The utility of post-traumatic skull X-rays.

The application of clinical guidelines for skull radiography in the accident and emergency department: Theory and practice

Significance of Shock in Head-iniured Patients with Skull Fracture.

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