Head injuries
Head injury results in 600 000 emergency department visits and 250 000 admissions per year in the pediatric age group in the United States. Of the children with multiple trauma, 80% will have some form of head injury.
Careful clinical assessment can identify the need for further investigation in those patients with closed head injury. In a retrospective analysis of 65 patients who underwent a computed tomographic (CT) scan for head trauma, all patients with CT abnormalities could have been classified as "severe" on clinical grounds alone. To be rated "severe" a patient had to have any one of the following clinical signs : (a) altered mental status, (b) clinical evidence of increased intracranial pressure (including persistent headache or persistent vomiting), (c) seizure or neurological deficit, or (d) scalp and/or facial injuries.
