Evaluating the Role of a Neurosurgery Consultation in Management of Pediatric Isolated Linear Skull Fractures
| Autor: | Ann M. Ritter, Jeffrey H. Haynes, Kavya Kommaraju |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Pneumocephalus Parietal bone fracture medicine Humans Child Referral and Consultation Retrospective Studies Skull Fractures business.industry General surgery Clinical course Glasgow Coma Scale Disease Management Infant Penetrating head trauma General Medicine medicine.disease Skull medicine.anatomical_structure Child Preschool 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Female Surgery Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery Pediatric trauma |
| Zdroj: | Pediatric Neurosurgery. 54:21-27 |
| ISSN: | 1423-0305 1016-2291 |
| DOI: | 10.1159/000495792 |
| Popis: | Background: The purpose of this study was to determine if a pediatric neurosurgical consultation for isolated linear skull fractures (ILSF) in pediatric patients with Glasgow Coma Scale (GCS) scores of ≥14 changed their management. Methods: A 10-year retrospective chart review at a Level 1 Pediatric Trauma Center was performed. Exclusion criteria were age > 18 years, open, depressed, or skull base fractures, pneumocephalus, poly-trauma, any hemorrhage (intraparenchymal, epidural, subdural, subarachnoid), cervical spine fractures, penetrating head trauma, and initial GCS scores ≤13. Primary outcomes were neurosurgery recommendations to change acuity of care, obtain additional imaging studies, and perform invasive procedures. Secondary outcomes were patient demographics, injury type, transfer status, admitting service, length of hospital stay, consult location, and clinical course. Results: There were 127 cases of ILSF meeting study criteria with an average age of 2.36 years. Unilateral parietal bone fracture was the most common injury (46.5%). Falls were the most common mechanism (81.1%). All patients received pediatric neurosurgical consultations within 24 h of hospital arrival. There were no neurosurgical recommendations to obtain additional imaging studies, change acuity of care, or perform invasive procedures. Conclusions: Routine neurosurgical consultation in children with ILSF and GCS 14–15 does not appear to alter clinical management. |
| Databáze: | OpenAIRE |
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