Palchak et al identified clinical findings associated with a low risk of brain injury in children after blunt head trauma. A child at low risk for brain injury may not require brain imaging studies. The authors are from the University of California Davis.

Patient selection: child after blunt head trauma


Outcome: traumatic brain injury requiring a neurosurgical procedure, requiring antiepileptic medication for more than 1 week, requiring hospitalization for >= 2 nights or having persistent neurologic deficits


A child is at low risk of brain injury if all of the following are present:

(1) normal mental status

(2) no clinical signs of skull fracture

(3) no history of vomiting

(4) no headache

(5) no scalp hematoma if age <= 2 years


The presence of one or more of the findings indicates some risk for brain injury.

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