Head Injury

Question 1

What are the indications for a CT head?

Answer 1

1. LoC >5 mins
2. Amnesia >5 mins
3. clinical suspicion of non accidental injury
4. three or more discrete episodes of vomiting
5. dangerous mechanism of injury
6. post-traumatic seizure
7. GCS below 14 on arrival or below 15 if under 1-year old
8. GCS under 15 2 hours after injury
9. abnormal drowsiness
10. swelling or laceration >5cm on head in under 1-year old
11. focal neurological deficit
12. basal skull fracture

Question 2

What are the signs of a basal skull fracture?

Answer 2

Raccoon eyes, postauricular bruising, CSF leak from nose or ear.

Question 3

What are the management of a head injury in a child?

Answer 3

1. ABCDE
2. safety net for signs of raised ICP
3. promote head injury prevention