Isolated linear skull fractures in children with blunt head trauma

Elizabeth C. Powell, Shireen M. Atabaki, Sandra Wootton-Gorges, David H Wisner, Prashant Mahajan, Todd Glass, Michelle Miskin, Rachel M. Stanley, Elizabeth Jacobs, Peter S. Dayan, James F Holmes Jr, Nathan Kuppermann

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVE: Children and adolescents with minor blunt head trauma and isolated skull fractures are often admitted to the hospital. The objective of this study was to describe the injury circumstances and frequency of clinically important neurologic complications among children with minor blunt head trauma and isolated linear skull fractures. METHODS: This study was a planned secondary analysis of a large prospective cohort study in children <18 years old with blunt head trauma. Data were collected in 25 emergency departments. We analyzed patients with Glasgow Coma Scale scores of 14 or 15 and isolated linear skull fractures. We ascertained acute neurologic outcomes through clinical information collected during admission or via telephone or mail at least 1 week after the emergency department visit. RESULTS: In the parent study, we enrolled 43 904 children (11 035 [25%] <2 years old). Of those with imaging studies, 350 had isolated linear skull fractures. Falls were the most common injury mechanism, accounting for 70% (81% for ages <2 years old). Of 201 hospitalized children, 42 had computed tomography or MRI repeated; 5 had new findings but none required neurosurgical intervention. Of 149 patients discharged from the hospital, 20 had repeated imaging, and none had new findings. CONCLUSIONS: Children with minor blunt head trauma and isolated linear skull fractures are at very low risk of evolving other traumatic findings noted in subsequent imaging studies or requiring neurosurgical intervention. Hospital admission for neurologically normal children with isolated linear skull fractures after minor blunt head trauma for monitoring is typically unnecessary.

Original languageEnglish (US)
Pages (from-to)e851-e857
JournalPediatrics
Volume135
Issue number4
DOIs
StatePublished - Apr 1 2015

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Skull Fractures
Craniocerebral Trauma
Nervous System
Hospital Emergency Service
Glasgow Coma Scale
Hospitalized Child
Wounds and Injuries
Postal Service
Telephone
Cohort Studies
Tomography
Prospective Studies

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Powell, E. C., Atabaki, S. M., Wootton-Gorges, S., Wisner, D. H., Mahajan, P., Glass, T., ... Kuppermann, N. (2015). Isolated linear skull fractures in children with blunt head trauma. Pediatrics, 135(4), e851-e857. https://doi.org/10.1542/peds.2014-2858

Isolated linear skull fractures in children with blunt head trauma. / Powell, Elizabeth C.; Atabaki, Shireen M.; Wootton-Gorges, Sandra; Wisner, David H; Mahajan, Prashant; Glass, Todd; Miskin, Michelle; Stanley, Rachel M.; Jacobs, Elizabeth; Dayan, Peter S.; Holmes Jr, James F; Kuppermann, Nathan.

In: Pediatrics, Vol. 135, No. 4, 01.04.2015, p. e851-e857.

Research output: Contribution to journalArticle

Powell, EC, Atabaki, SM, Wootton-Gorges, S, Wisner, DH, Mahajan, P, Glass, T, Miskin, M, Stanley, RM, Jacobs, E, Dayan, PS, Holmes Jr, JF & Kuppermann, N 2015, 'Isolated linear skull fractures in children with blunt head trauma', Pediatrics, vol. 135, no. 4, pp. e851-e857. https://doi.org/10.1542/peds.2014-2858
Powell EC, Atabaki SM, Wootton-Gorges S, Wisner DH, Mahajan P, Glass T et al. Isolated linear skull fractures in children with blunt head trauma. Pediatrics. 2015 Apr 1;135(4):e851-e857. https://doi.org/10.1542/peds.2014-2858
Powell, Elizabeth C. ; Atabaki, Shireen M. ; Wootton-Gorges, Sandra ; Wisner, David H ; Mahajan, Prashant ; Glass, Todd ; Miskin, Michelle ; Stanley, Rachel M. ; Jacobs, Elizabeth ; Dayan, Peter S. ; Holmes Jr, James F ; Kuppermann, Nathan. / Isolated linear skull fractures in children with blunt head trauma. In: Pediatrics. 2015 ; Vol. 135, No. 4. pp. e851-e857.
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