https://wikem.org/w/api.php?action=feedcontributions&feedformat=atom&user=XavierstaceyWikEM - User contributions [en]2026-05-26T17:22:41ZUser contributionsMediaWiki 1.38.2https://wikem.org/w/index.php?title=Head_trauma_(peds)&diff=15014Head trauma (peds)2013-12-08T03:29:33Z<p>Xavierstacey: Line break.</p>
<hr />
<div>== Definition ==<br />
*Normal mental status at the initial examination<br />
*No abnormal findings on neuro exam<br />
*No physical evidence of skull fx<br />
<br />
== Background ==<br />
*Persistence of HA, confusion, and amnesia suggests concussion<br />
*Worsening of symptoms suggests intracranial injury<br />
*Scalp hematoma in <2yo is assoc w/ incr risk of skull fx, ICH<br />
*Clinical symptoms (HA, vomiting, behavior change) do not correlate well with ICH<br />
<br />
== Work-Up ==<br />
<br />
(Consider PECARN Study. PECARN Pediatric Head Injury/Trauma Algorithm at http://www.mdcalc.com/pecarn-pediatric-head-injury-trauma-algorithm/)<br><br><br />
Do I need to obtain a head CT?<br />
===<2yr old===<br />
*No CT is necessary if ALL are found:<br />
#Normal mental status<br />
#No scalp hematoma except frontal<br />
##LOC <5s<br />
#Non-severe mechanism<br />
##Severe mechanism = pedestrian or bicyclist w/ohelmet struck by motorized vehicle<br />
##Severe mechanism = fall >1m or 3ft<br />
##Severe mechanism = head struck by high-impact object<br />
#No palpable skull fracture<br />
#Normal behavior per parents<br />
<br />
===>2yr old===<br />
*No CT is necessary if ALL are found:<br />
#Normal mental status<br />
#No LOC<br />
#No vomiting<br />
#^Non-severe mechanism<br />
##Severe mechanism = pedestrian or bicyclist w/ohelmet struck by motorized vehicle<br />
##Severe mechanism = fall >2m or 5ft<br />
##Head struck by high-impact object<br />
#No signs of basilar skull fracture<br />
#No severe headache<br />
<br />
==Disposition==<br />
*Discharge if:<br />
**Asymptomatic after 2-4hr obs (not vomiting, nl neuro exam, nl mental status)<br />
**Head CT normal (delayed deterioration after normal CT is near zero)<br />
*Consider discharge if:<br />
**Nondisplaced fx w/o intracranial injury (in consultation w/ neurosx)<br />
<br />
== See Also ==<br />
*[[GCS (Peds)]]<br />
*[[Concussion]]<br />
*[[Skull Fracture]]<br />
*[[Abuse (Nonaccidental Trauma)]]<br />
*[[Head Trauma (Adult)]]<br />
*[[Maxillofacial Trauma]]<br />
<br />
== Source ==<br />
*Tintinalli<br />
*Kupperman N, Holmes JF, Dayan PS, et al: Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696): 1160, 2009<br />
*Holmes et al. Do Children With Blunt Head Trauma and Normal Cranial CT Require Hospitalization for Neurologic Observation?, Annals of Emergency Medicine, vol 58, 2011<br />
<br />
[[Category:Peds]] <br />
[[Category:Trauma]]</div>Xavierstaceyhttps://wikem.org/w/index.php?title=Head_trauma_(peds)&diff=15013Head trauma (peds)2013-12-08T03:29:14Z<p>Xavierstacey: Line break.</p>
<hr />
<div>== Definition ==<br />
*Normal mental status at the initial examination<br />
*No abnormal findings on neuro exam<br />
*No physical evidence of skull fx<br />
<br />
== Background ==<br />
*Persistence of HA, confusion, and amnesia suggests concussion<br />
*Worsening of symptoms suggests intracranial injury<br />
*Scalp hematoma in <2yo is assoc w/ incr risk of skull fx, ICH<br />
*Clinical symptoms (HA, vomiting, behavior change) do not correlate well with ICH<br />
<br />
== Work-Up ==<br />
<br />
(Consider PECARN Study. PECARN Pediatric Head Injury/Trauma Algorithm at http://www.mdcalc.com/pecarn-pediatric-head-injury-trauma-algorithm/)<br><br />
Do I need to obtain a head CT?<br />
===<2yr old===<br />
*No CT is necessary if ALL are found:<br />
#Normal mental status<br />
#No scalp hematoma except frontal<br />
##LOC <5s<br />
#Non-severe mechanism<br />
##Severe mechanism = pedestrian or bicyclist w/ohelmet struck by motorized vehicle<br />
##Severe mechanism = fall >1m or 3ft<br />
##Severe mechanism = head struck by high-impact object<br />
#No palpable skull fracture<br />
#Normal behavior per parents<br />
<br />
===>2yr old===<br />
*No CT is necessary if ALL are found:<br />
#Normal mental status<br />
#No LOC<br />
#No vomiting<br />
#^Non-severe mechanism<br />
##Severe mechanism = pedestrian or bicyclist w/ohelmet struck by motorized vehicle<br />
##Severe mechanism = fall >2m or 5ft<br />
##Head struck by high-impact object<br />
#No signs of basilar skull fracture<br />
#No severe headache<br />
<br />
==Disposition==<br />
*Discharge if:<br />
**Asymptomatic after 2-4hr obs (not vomiting, nl neuro exam, nl mental status)<br />
**Head CT normal (delayed deterioration after normal CT is near zero)<br />
*Consider discharge if:<br />
**Nondisplaced fx w/o intracranial injury (in consultation w/ neurosx)<br />
<br />
== See Also ==<br />
*[[GCS (Peds)]]<br />
*[[Concussion]]<br />
*[[Skull Fracture]]<br />
*[[Abuse (Nonaccidental Trauma)]]<br />
*[[Head Trauma (Adult)]]<br />
*[[Maxillofacial Trauma]]<br />
<br />
== Source ==<br />
*Tintinalli<br />
*Kupperman N, Holmes JF, Dayan PS, et al: Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696): 1160, 2009<br />
*Holmes et al. Do Children With Blunt Head Trauma and Normal Cranial CT Require Hospitalization for Neurologic Observation?, Annals of Emergency Medicine, vol 58, 2011<br />
<br />
[[Category:Peds]] <br />
[[Category:Trauma]]</div>Xavierstaceyhttps://wikem.org/w/index.php?title=Head_trauma_(peds)&diff=15012Head trauma (peds)2013-12-08T03:28:51Z<p>Xavierstacey: Added pointer to PECARN study from which the guidelines on this page arise.</p>
<hr />
<div>== Definition ==<br />
*Normal mental status at the initial examination<br />
*No abnormal findings on neuro exam<br />
*No physical evidence of skull fx<br />
<br />
== Background ==<br />
*Persistence of HA, confusion, and amnesia suggests concussion<br />
*Worsening of symptoms suggests intracranial injury<br />
*Scalp hematoma in <2yo is assoc w/ incr risk of skull fx, ICH<br />
*Clinical symptoms (HA, vomiting, behavior change) do not correlate well with ICH<br />
<br />
== Work-Up ==<br />
<br />
(Consider PECARN Study. PECARN Pediatric Head Injury/Trauma Algorithm at http://www.mdcalc.com/pecarn-pediatric-head-injury-trauma-algorithm/)<br />
<br />
Do I need to obtain a head CT?<br />
===<2yr old===<br />
*No CT is necessary if ALL are found:<br />
#Normal mental status<br />
#No scalp hematoma except frontal<br />
##LOC <5s<br />
#Non-severe mechanism<br />
##Severe mechanism = pedestrian or bicyclist w/ohelmet struck by motorized vehicle<br />
##Severe mechanism = fall >1m or 3ft<br />
##Severe mechanism = head struck by high-impact object<br />
#No palpable skull fracture<br />
#Normal behavior per parents<br />
<br />
===>2yr old===<br />
*No CT is necessary if ALL are found:<br />
#Normal mental status<br />
#No LOC<br />
#No vomiting<br />
#^Non-severe mechanism<br />
##Severe mechanism = pedestrian or bicyclist w/ohelmet struck by motorized vehicle<br />
##Severe mechanism = fall >2m or 5ft<br />
##Head struck by high-impact object<br />
#No signs of basilar skull fracture<br />
#No severe headache<br />
<br />
==Disposition==<br />
*Discharge if:<br />
**Asymptomatic after 2-4hr obs (not vomiting, nl neuro exam, nl mental status)<br />
**Head CT normal (delayed deterioration after normal CT is near zero)<br />
*Consider discharge if:<br />
**Nondisplaced fx w/o intracranial injury (in consultation w/ neurosx)<br />
<br />
== See Also ==<br />
*[[GCS (Peds)]]<br />
*[[Concussion]]<br />
*[[Skull Fracture]]<br />
*[[Abuse (Nonaccidental Trauma)]]<br />
*[[Head Trauma (Adult)]]<br />
*[[Maxillofacial Trauma]]<br />
<br />
== Source ==<br />
*Tintinalli<br />
*Kupperman N, Holmes JF, Dayan PS, et al: Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696): 1160, 2009<br />
*Holmes et al. Do Children With Blunt Head Trauma and Normal Cranial CT Require Hospitalization for Neurologic Observation?, Annals of Emergency Medicine, vol 58, 2011<br />
<br />
[[Category:Peds]] <br />
[[Category:Trauma]]</div>Xavierstacey