Document Detail

Isolated head injuries versus multiple trauma in pediatric patients: do the same indications for cervical spine evaluation apply?
MedLine Citation:
PMID:  7865406     Owner:  NLM     Status:  MEDLINE    
Although the recommendations to evaluate possible cervical spine injuries in patients with isolated head injuries are identical to those with multiple trauma, to date, no such study has confirmed that risk factors are the same for both injuries. We reviewed the charts of 268 pediatric patients with isolated head injuries admitted to the Intensive Care Unit at Children's Hospital Medical Center (1985-1990) to determine which risk factors were present. In this retrospective study, we divided the patients into two groups: low risk and high risk. The low-risk patients (n = 135) were those capable of verbal communication who did not report cervical discomfort. The high-risk patients (n = 133) either were incapable of verbal communication (preverbal or physically unable due to head injury) or reported neck pain. All patients under 2 years of age were considered preverbal and at high risk. The patients in both groups were indistinguishable by age, sex, mechanism of injury, and type of injury sustained. No patient in the low-risk group suffered cervical spine injury. Cervical spine trauma was present in 10 (7.5%) high-risk patients. Using the method of adjusted odds ratio, we found that high-risk patients had 23 times the likelihood of neck injury when compared with low-risk patients (p = 0.003, 95% confidence limit). Our results indicate that cervical spine X-rays (i.e., anteroposterior, odontoid, lateral views) are indicated only in high-risk pediatric patients with head injuries who either complain of neck pain or cannot voice such complaints because of significant head injury or preverbal age.(ABSTRACT TRUNCATED AT 250 WORDS)
J L Laham; D H Cotcamp; P A Gibbons; M D Kahana; K R Crone
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  21     ISSN:  1016-2291     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  1994  
Date Detail:
Created Date:  1995-03-30     Completed Date:  1995-03-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  221-6; discussion 226     Citation Subset:  IM    
Department of Critical Care, Children's Hospital Medical Center, Cincinnati, Ohio.
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MeSH Terms
Cervical Vertebrae / injuries*,  pathology
Child, Preschool
Craniocerebral Trauma / diagnosis*,  epidemiology,  etiology
Dislocations / diagnosis,  epidemiology,  etiology
Intensive Care Units, Pediatric
Magnetic Resonance Imaging
Multiple Trauma / diagnosis*,  epidemiology,  etiology
Retrospective Studies
Risk Factors
Spinal Fractures / diagnosis,  epidemiology,  etiology
Spinal Injuries / diagnosis*,  epidemiology,  etiology
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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