Biomechanical factors in patient selection for radiography after head injury

doi:10.1016/0020-1383(93)90153-W

Injury

Volume 24, Issue 7, August 1993, Pages 471-475

https://doi.org/10.1016/0020-1383(93)90153-W Get rights and content

Abstract

In order to assess the predictive value of certain biomechanical parameters for skull fracture after head injury, a prospective analysis was undertaken of a series of 5416 head-injured patients. In each case an assessment was made at presentation as to the velocity of impact and the physical properties of the impacting agent. The incidence of skull vault fracture was then calculated for injuries sustained at different velocities and for different types of contact. The incidence of fracture was also calculated with respect to the presence of post-traumatic amnesia (PTA).

The incidences (95 per cent confidence intervals) of skull fracture at low, medium and high speeds were 0.17(0.0427–0.433), 1.99 (1.47–2.63) and 10.2 (7.41–12.6) per cent respectively. Fractures tended to occur with greater frequency after impacts against broad hard surfaces or small objects rather than against broad soft objects. The percentage incidence of fracture in adults suffering more than 5 min of PTA was 17.93 (12.4–23.5) compared with 0.674 (0.372–1.1) in those without amnesia.

Patient selection for skull radiography after an apparently minor head injury can be guided by an assessment of post-traumatic amnesia and the biomechanics of the injury.

References (24)

J.A. Clarke et al.
The application of clinical guidelines for skull radiography in the accident and emergency department: theory and practice
Clin. Radiol.
(1990)
D. Gorman
Skull X-rays after head injury
Lancet
(1987)
J.D. Miller et al.
The work of a Regional Head Injury Service
Lancet
(1985)
J.D. Miller et al.
Complications of depressed skull fractures
Lancet
(1968)
K. Thillainayagam et al.
How accurately are fractures of the skull diagnosed in an accident and emergency department?
Injury
(1987)
B. Aldman et al.
The structure of European research into the biomechanics of impact
AAAM Q. J.
(1986)
R.S. Bell et al.
The utility and futility of radiographic skull examination for trauma
N. Engl. J. Med.
(1971)
M. Briggs et al.
Guidelines for initial management after head injury in adults: suggestions from a group of neurosurgeons
Br. Med. J.
(1984)
M.J. Gardner et al.
T.A. Gennarelli
Head injury in man and experimental animals: clinical aspects
Acta Neurochir.
(1983)

D.F. Gorman

The utility of post-traumatic skull X-rays

Arch. Emerg. Med.

(1987)

E.S. Gurdjian et al.

The mechanism of skull fracture

J. Neurosurg.

(1949)

Cited by (10)

Examples in biomechanics
2018, Engineering Standards for Forensic Application
Biomechanics for forensic methods can be defined as the study of how the human body fails structurally when challenged by a fall, a motor vehicle collision, an aircraft crash, a malfunction of a machine, or one of a myriad of events such as a drowning or a criminal act. For humans, biomechanics can also refer to the study of how the skeletal and musculature systems work under different conditions. Scientists and engineers often try to apply physics, mechanics, and thermodynamics methods to the analysis of the human body during these events to determine, first, what happens and, second, the effects of the event on the human body.
Strategy for medical imaging
1999, Annales Francaises d'Anesthesie et de Reanimation
Strategy for medical imaging
1998, Reanimation Urgences
Methodological issues and research recommendations for mild traumatic brain injury: The WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury
2004, Journal of Rehabilitation Medicine, Supplement
Diagnostic procedures in mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury
2004, Journal of Rehabilitation Medicine, Supplement
Significance of vomiting after head injury
1999, Journal of Neurology Neurosurgery and Psychiatry

View all citing articles on Scopus

View full text

PaperBiomechanical factors in patient selection for radiography after head injury

Abstract

Clin. Radiol.

Lancet

Lancet

Lancet

Injury

The structure of European research into the biomechanics of impact

AAAM Q. J.

The utility and futility of radiographic skull examination for trauma

N. Engl. J. Med.

Guidelines for initial management after head injury in adults: suggestions from a group of neurosurgeons

Br. Med. J.

Head injury in man and experimental animals: clinical aspects

Acta Neurochir.

The utility of post-traumatic skull X-rays

Arch. Emerg. Med.

The mechanism of skull fracture

J. Neurosurg.

Paper
Biomechanical factors in patient selection for radiography after head injury