Bedside Ultrasonographic Evaluation of Skull Fractures in Pediatric Head Trauma Patients Admitted to Emergency Department

Abstract

Objective: Among children with minor head trauma, the incidence of skull fractures is increased especially in those under one year of age. Several studies investigated the association between skull fracture and traumatic brain injury. In the present study, we aimed to test the potential of ultrasonography in detecting linear skull fracture in pediatric patients with minor head trauma. Methods: Patients under the age of 18 years with minor head trauma who presented to the emergency units of Bozok University Faculty of Medicine or Ordu University Training and Research Hospital between March 1, 2019 and November 1, 2019 and were planned to undergo head CT by their responsible physicians were included in the present study. The exclusion criteria were a Glasgow Coma Scale (GCS) score <14, traumatic open skull deformity, depressed skull fracture, penetrating head trauma, and hemodynamic instability. Results: A total of 62 patients (%64,5 males) with a mean age of 7.29 years were included. The sensitivity and specificity of ultrasound in detection of fractures were %84.6 (% 95 CI: 65.13- 95.6) and % 94.4 (% 95 CI: 81.3-99.3), respectively. Conclusion: In conclusion, we suggest that the use of ultrasound before CT examination in patients with minor head trauma may be a helpful means to detect cranial fractures.