Defining acute mild head injury in adults: A proposal based on prognostic factors, diagnosis, and management

Servadei, F., Teasdale, G. and Merry, G. (2001) Defining acute mild head injury in adults: A proposal based on prognostic factors, diagnosis, and management. Journal of Neurotrauma, 18 7: 657-664. doi:10.1089/089771501750357609


Author Servadei, F.
Teasdale, G.
Merry, G.
Title Defining acute mild head injury in adults: A proposal based on prognostic factors, diagnosis, and management
Journal name Journal of Neurotrauma   Check publisher's open access policy
ISSN 0897-7151
Publication date 2001-01-01
Sub-type Article (original research)
DOI 10.1089/089771501750357609
Open Access Status Not yet assessed
Volume 18
Issue 7
Start page 657
End page 664
Total pages 8
Publisher Mary Ann Liebert Inc.
Language eng
Subject 2728 Clinical Neurology
Abstract The lack of a common, widely acceptable criterion for the definition of trivial, minor, or mild head injury has led to confusion and difficulty in comparing findings in published series. This review proposes that acute head-injured patients previously described as minor, mild, or trivial are defined as "mild head injury," and that further groups are recognized and classified as "low-risk mild head injury," "medium risk mild head injury," or "high-risk mild head injury." Low-risk mild injury patients are those with a Glasgow Coma Score (GCS) of 15 and without a history of loss of consciousness, amnesia, vomiting, or diffuse headache. The risk of intracranial hematoma requiring surgical evacuation is definitively less than 0.1:100. These patients can be sent home with written recommendations. Medium risk mild injury patients have a GCS of 15 and one or more of the following symptoms: loss of consciousness, amnesia, vomiting, or diffuse headache. The risk of intracranial hematoma requiring surgical evacuation is in the range of 1-3:100. Where there is one computed tomography (CT) scanner available in an area for 100,000 people or less, a CT scan should be obtained for such patients. If CT scanning is not so readily available, adults should have a skull x-ray and, if this shows a fracture, should be moved to the "high-risk" category and undergo CT scanning. High-risk mild head injury patients are those with an admission GCS of 14 or 15, with a skull fracture and/or neurological deficits. The risk of intracranial hematoma requiring surgical evacuation is in the range 6-10:100. If a CT scan is available for 500,000 people or less, this examination must be obtained. Patients with one of the following risk factors - coagulopathy, drug or alcohol consumption, previous neurosurgical procedures, pretrauma epilepsy, or age over 60 years - are included in the high-risk group independent of the clinical presentation.
Keyword Computed tomography scan
Mild head injury
Skull x-ray
Traumatic hematomas
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Scopus Import - Archived
 
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Created: Fri, 22 Dec 2017, 10:59:42 EST