Yuksen et al reported a clinical score for predicting intracranial hemorrhage in patients with mild traumatic brain injury (TBI). The authors are from multiple institutions in Thailand.
Patient selection: mild traumatic brain injury
Parameters:
(1) number of episodes of posttraumatic vomiting
(2) severe headache
(3) transient loss of consciousness (LOC)
(4) posttraumatic amnesia
(5) focal neurological signs
(6) clinical signs of skull fracture
(7) base of skull fracture
Parameter
Finding
Points
posttraumatic vomiting
0 to 2 times
0
3 or more times
1.5
severe headache
no
0
yes
7.5
transient LOC
no
0
yes
3
posttraumatic amnesia
no
0
yes
1
focal neurological signs
no
0
yes
4
clinical signs of skull fracture
no
0
yes
6
base of skull fracture
no
0
yes
8
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 31
• The higher the score the greater the risk of intracranial hemorrhage.
Total Score
Risk Group
Likelihood Ratio
0 to 2.5
low
0.13
3 to 6
moderate
1.5
> 6
high
20.6
Performance:
• The area under the ROC curve is 0.92.
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