Investigation of the Correlation between Scalp Hematoma and Cranial Fractures and Intracranial Lesions in Children Presenting with Minor Head Trauma

Minor head trauma is one of the common causes of pediatric reference to emergency ward. This study investigated the correlation between scalp hematoma,cranial fractures and intracranial lesions in children presenting with minor head traumata.

This was a descriptive cross-sectional study. The data gathering were done in 2016-17. All children under 18 years of age (933 individuals) who referred to Shahid Rahnemoun Pediatric Emergency Center in Yazd with a complaint of minor head trauma and underwent a CT scan according to American Academy Criteria were included in the study. The mean age of the children was 11.67 years. CT scan of 209 patients (%22.41) reported scalp hematoma. A radiologist who did not have any information about the study was asked to interpret the CT scans using a predesigned checklist. Finally, the data were encoded into an Excel file and statistically analyzed by STATA10 software using Chi-square test and logistic regression.

The scalp hematoma was significantly related to intraventricular hemorrhage (P<0.001), subarachnoid hemorrhage (P<0.001), intracerebral hemorrhage (P<0.001), cerebral edema (P<0.001), subepidural hemorrhage (P<0.001), cerebral concussion (P<0.001), cerebral shift (P<0.001), pneumocephalus (P<0.001), and cranial fracture (P<0.001); however, scalp hematoma was not significantly related to diffuse axonal injury (P=0.27).

Our findings confirmed the importance of presence of scalp hematoma in clinical assessment of children with minor head trauma aged less than 18 years. It is recommended that children with minor head trauma be treated and evaluated more in the emergency department more vigilantly and meticulously.