Journal article
Clinical Outcomes in Neurologically Intact Children With Small Intracranial Bleeds and Simple Skull Fractures
Curēus (Palo Alto, CA), v 15(8), pp e42848-e42848
02 Aug 2023
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction
Children with minor intracranial hemorrhage (ICH) and/or simple skull fractures are often hospitalized for monitoring; however, the majority do not require any medical, surgical, or critical care interventions. Our purpose was to determine the rate of significant clinical sequela (SCS) and identify associated risk factors in neurologically intact children with close head trauma.
Methods
This is a retrospective observational study. Children (≤ 3 years of age) admitted with closed head trauma, documented head injuries (ICH ≤ 5mm and/or simple skull fracture), and a Glasgow Coma Scale (GCS) score of ≥14, between January 2015 and January 2020, were included. We collected demographics, resource utilization, and patient outcomes variables. SCS was defined as any radiologic progression, and/or clinically important medical or neurological deterioration.
Results
A total of 205 patients were enrolled in the study (65.4% male, mean age 7.7 months). Repeat neuroimaging was obtained in 41/205 patients (20%) with radiologic progression noted in 5/205 (2.4%). Thirteen out of 205 patients (6.3%) experienced SCS. Patients with SCS were more likely to be males (92.3% vs 63.5% in females, P=0.035) to have had a report filed with child protective services due to a concern for abuse/neglect (92.3% vs 61.5% in females, P=0.025), and to have had a non-linear skull fracture (P<0.001). No other factors were shown to be predictive of SCS with enough statistical significance.
Conclusion
Neurologically intact children with traumatic closed head injury are at low risk for developing SCS. This study suggests that most of these children may not need ICU monitoring. This study also showed that a certain subset might be at an increased risk of developing SCS.
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Details
- Title
- Clinical Outcomes in Neurologically Intact Children With Small Intracranial Bleeds and Simple Skull Fractures
- Creators
- Mohamed Almuqamam - Pediatric Critical Care Medicine, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, USA Neurosurgery, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, USA Pediatric Surgery, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, USA Child Protection Program, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, USATina C Loven - Drexel UniversityLindsay G Arthur III - Pediatric Critical Care Medicine, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, USA Neurosurgery, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, USA Pediatric Surgery, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, USA Child Protection Program, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, USANorrell K Atkinson - Drexel UniversityHarsh Grewal - Drexel University
- Publication Details
- Curēus (Palo Alto, CA), v 15(8), pp e42848-e42848
- Publisher
- Cureus
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics; Surgery
- Web of Science ID
- WOS:001047624400024
- Other Identifier
- 991021448041404721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology