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Japanese

A Guide to Initial Management of Minor Head Injury Naoto SHIOMI 1 , Tadashi ECHIGO 2 1Department of Neurosurgery,Kurume University School of Medicine 2Department of Neurosurgery,Saiseikai Shigaken Hospital Keyword: minor head injury , GCS score of 15 , skull X-ray , CT , acute epidural hematoma pp.465-470
Published Date 2004/5/1
DOI https://doi.org/10.11477/mf.1436100383
  • Abstract
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 We reviewed the records of 1,335 minor head injury patients with initial Glasgow Coma Scale (GCS) scores of 15 treated by our neurosurgery service between January 1998 and December 2000. Skull X-ray was performed in 945 patients (71%),and Computed tomography (CT) was performed in 590 patients (44%). Skull fracture was shown radiographically in 24 patients (2.5%),and abnormalities on the initial CT were seen in 29 patients (4.9%). The most frequent intracranial lesion on CT was acute epidural hematoma with skull fracture.

 Significantly more intracranial lesions were found in those with a fracture than in those without by c2 analysis. Post-traumatic vomiting was significantly associated with radiographical abnormalities,but headache and nausea did not increase the risk of skull fracture and intracranial lesions on the CT. Patients required neurosurgical intervention in 4 cases,and all of those were acute epidural hematoma with skull fracture.

 In this study,the first thing we should do for asymptomatic minor head injury patients with a GCS score of 15 is to investigate the presence of a skull fracture by skull X-ray. Head trauma patients with a skull fracture and post-traumatic vomiting should undergo CT to facilitate detection of intracranial lesions,even when there are no abnormal neurological signs.


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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