Is a skull X-ray necessary after milder head trauma?

Br J Neurosurg. 1991;5(2):135-9. doi: 10.3109/02688699108998459.


During the 2-year period 1985-86 a total of 1,876 patients were admitted to our hospital after milder head trauma including cerebral concussion. Two hundred and eighty four patients who had a skull X-ray were not selected from guidelines. In 1,592 patients without a skull X-ray, signs of an intracranial complication developed in six cases and were verified by CT. In the 284 patients with skull X-ray a fracture was demonstrated in 25, and of these 25 patients only one patient disclosed a cerebral contusion. In the 259 patients with skull X-ray, but without demonstration of fracture, there were subsequently seen one subdural haematoma and one cerebral contusion. The incidence of intracranial complications in patients without and with skull X-ray with or without fracture does not differ significantly. In these circumstances we do not find any justification for routine skull X-ray after milder head trauma.

MeSH terms

  • Brain Concussion / diagnostic imaging
  • Brain Concussion / etiology
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / etiology
  • Craniocerebral Trauma / diagnostic imaging*
  • Denmark
  • Diagnostic Tests, Routine / economics
  • Diagnostic Tests, Routine / statistics & numerical data*
  • Evaluation Studies as Topic
  • Humans
  • Radiography
  • Risk
  • Skull / diagnostic imaging*
  • Skull Fractures / complications
  • Skull Fractures / diagnostic imaging