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Journal of the Korean Society of Traumatology 2006;19(1):8-13.
The Relationship Between Type and Size of Scalp Injury and Intracranial Injury Among Patients who Visited the Emergency room due to head Trauma
Yong Sung Kim, Hoon Lim, Young Soon Cho, Ho Jung Kim
Department of Emergency Medicine, Soon Chun Hyang University College of Medicine, Bucheon, Korea. emhoney@schbc.ac.kr
두부손상으로 응급실에 내원한 환자의 두피손상 양상, 크기와 두 개내 손상과의 관련성
김용성·임 훈·조영순·김호중
임 훈
Abstract
PURPOSE
Traumatic head injury is very common in the emergency room. Early diagnosis and treatment can significantly reduce mortality and morbidity. When diagnosis is delayed, however, it could be critical to the patients. In reality, it is difficult to take a brain CT for all patients with head trauma, so this study examined the relationship between type and size of scalp injury and intracranial injury.
METHODS
This prospective study was conducted from May 2005 to July 2005. The participants were 193 patients who had had a brain CT. Head trauma included obvious external injury or was based on reports of witnesses to the accident. Children under three years of age were also included if there was a witness to the accident. The size of the injury was measured based on the maximum diameter.
RESULTS
Out of the total of 193 patients, patients with scalp bleeding totaled 126 (65.2%), and patients without scalp bleeding totaled 67 (34.8%). Among patients with scalp bleeding, patients with intracranial injuries numbered nine, and among patients without scalp bleeding, patients with intracranial injuries numbered 17 (P=0.001). Among patients who showed evidence of scalp swelling with no scalp bleeding, the relationship between the size of the scalp swelling and intracranial injury was statistically significant when the size of the scalp swelling was between 2 cm and 5 cm.
CONCLUSION
Among patients who visit an emergency medical center due to traumatic head injury, patients with no scalp bleeding, but with scalp swelling between 2 cm and 5 cm, should undergone more accurate and careful examination, as well as as a brain CT.
Key Words: Brain injury; Traumatic intracranial hemorrhage


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