© 2004 BMJ Publishing Group & Royal College of Paediatrics and Child Health
COMMENTARY
Head trauma
Intracranial injury in minor head trauma
Correspondence to:
Correspondence to:
Dr N Kuppermann
Division of Emergency Medicine, UC Davis Medical Center, 2315 Stockton Blvd, PSSB Bldg, Suite 2100, Sacramento, CA 98517, USA; nkuppermann@ucdavis.edu
Commentary on the paper by Dunning et al (see page 653)
Abbreviations: CT, computed tomography; ED, emergency department; GCS, Glasgow Coma Scale; TBI, traumatic brain injury
Keywords: brain injury; head trauma; minor head trauma
| The first 150 words of the full text of this article appear below. |
Traumatic brain injury (TBI) is a leading cause of childhood death and disability worldwide. In the United States, childhood head trauma results in 3000 deaths, 50 000 hospitalisations, and 650 000 emergency department (ED) visits annually.1,2 Children with seemingly minor head trauma, defined here by Glasgow Coma Scale (GCS) scores of 14–15, account for 40–59% of those with TBIs,3–5 and present a perplexing problem to clinicians. Despite the frequency of childhood minor head trauma, there exists no highly accurate and reliable clinical scoring system for separating those children with minor head trauma at negligible risk of TBI from those at greater risk. Children with TBIs who present with signs of seemingly minor head trauma are at risk for delayed diagnosis and treatment, and such unrecognised TBIs are a source of preventable morbidity.6–8 Nevertheless, although some TBIs in children with minor head trauma are initially unrecognised and therefore neuroimaging
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