The significance of skull fracture in mild head trauma differs between children and adults

Childs Nerv Syst. 2005 Feb;21(2):128-32. doi: 10.1007/s00381-004-1036-x. Epub 2004 Aug 24.


Objective: The objective was to determine whether the age of patients with mild head injury and skull fracture influences the level of risk for acute intracranial injuries.

Method: A study was conducted of 156 patients with skull fracture, 60 children (aged <14 years) and 96 adults, detected among 5,097 consecutive patients with mild head injury (Glasgow Coma Scale [GCS] score of 15-14 points) arriving at the Emergency Department of a Level I University Hospital Trauma Center during 1998. Acute intracranial injuries were defined as traumatic brain injuries identified by cranial computed tomography scan, excluding pneumocephalus.

Results: Compared with the children, this risk of intracranial injury was 13 times greater in the adults aged 14-54 years and 16 times greater in the over-54-year-olds. Besides age over 14 years (p<0.0001), compound skull fracture (p<0.001), and a GCS score of 14 (p<0.001) were factors significantly associated with intracranial injury in the logistic regression analysis.

Conclusions: Skull fracture in mild head injury implies a greater risk of intracranial injury in adults than in children.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / pathology*
  • Female
  • Glasgow Coma Scale / statistics & numerical data
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Neurologic Examination
  • Retrospective Studies
  • Risk Factors
  • Skull Fractures / etiology*
  • Skull Fractures / pathology*
  • Tomography, X-Ray Computed