Minimal head trauma in children revisited: Is routine hospitalization required?

Sean P. Roddy, Stephen M. Cohn, Beth A. Moller, Charles C. Duncan, John R. Gosche, John H. Seashore, Robert J. Touloukian

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective. Children with a question of occult head injury are routinely hospitalized despite having both normal central nervous system (CNS) and computed tomographic (CT) scan examinations. We determined the incidence of significant CNS morbidity after occult head injury to determine whether or not hospital admission was necessary in children after minimal head trauma. Methods. We reviewed the records of children admitted to a level I trauma center with a question of closed head injury, an initial Glasgow Coma Scale equal to 15, a normal neurologic exam, and a normal head CT scan. Children with associated injuries requiring admission were excluded. The endpoints were deterioration in CNS exam, new CT findings, and the need for a prolonged hospital stay. Results. Sixty-two patients were studied with a mean age of 7 years (range, 1 month to 15 years), and 65% were male. The primary mechanisms of injury were fall (45%) and vehicular crash (23%). The mean injury severity score was 4 ± 2. The mean length of stay was 1.2 days (range, 1 to 3 days). Prolonged hospitalization occurred in 9 patients (15%). No child developed significant CNS sequelae warranting hospital admission. Total charges for these hospitalization were $177 874. Conclusions. Children undergoing emergency department work-up of occult head injury, who have a normal CNS exam and a normal head CT scan, do not seem to be at risk for significant CNS sequelae. These patients can be discharged home with parental supervision and avoid unnecessary and costly hospitalization.

Original languageEnglish (US)
Pages (from-to)575-577
Number of pages3
JournalPediatrics
Volume101
Issue number4 I
DOIs
StatePublished - Apr 1998
Externally publishedYes

Fingerprint

Craniocerebral Trauma
Hospitalization
Central Nervous System
Length of Stay
Head
Closed Head Injuries
Glasgow Coma Scale
Injury Severity Score
Trauma Centers
Wounds and Injuries
Nervous System
Hospital Emergency Service
Morbidity
Incidence

Keywords

  • Brain injury
  • CT scan
  • Pediatric injuries
  • Trauma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Roddy, S. P., Cohn, S. M., Moller, B. A., Duncan, C. C., Gosche, J. R., Seashore, J. H., & Touloukian, R. J. (1998). Minimal head trauma in children revisited: Is routine hospitalization required? Pediatrics, 101(4 I), 575-577. https://doi.org/10.1542/peds.101.4.575

Minimal head trauma in children revisited : Is routine hospitalization required? / Roddy, Sean P.; Cohn, Stephen M.; Moller, Beth A.; Duncan, Charles C.; Gosche, John R.; Seashore, John H.; Touloukian, Robert J.

In: Pediatrics, Vol. 101, No. 4 I, 04.1998, p. 575-577.

Research output: Contribution to journalArticle

Roddy, SP, Cohn, SM, Moller, BA, Duncan, CC, Gosche, JR, Seashore, JH & Touloukian, RJ 1998, 'Minimal head trauma in children revisited: Is routine hospitalization required?', Pediatrics, vol. 101, no. 4 I, pp. 575-577. https://doi.org/10.1542/peds.101.4.575
Roddy SP, Cohn SM, Moller BA, Duncan CC, Gosche JR, Seashore JH et al. Minimal head trauma in children revisited: Is routine hospitalization required? Pediatrics. 1998 Apr;101(4 I):575-577. https://doi.org/10.1542/peds.101.4.575
Roddy, Sean P. ; Cohn, Stephen M. ; Moller, Beth A. ; Duncan, Charles C. ; Gosche, John R. ; Seashore, John H. ; Touloukian, Robert J. / Minimal head trauma in children revisited : Is routine hospitalization required?. In: Pediatrics. 1998 ; Vol. 101, No. 4 I. pp. 575-577.
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