THE VALUE OF CONVENTIONAL SKULL X-RAYS FO LLOWING HEAD-INJURIES

A retrospective study was used in an attempt to clarify whether skull fractures or clinical findings can be used for diagnosing intracranial injuries and which clinical features indicate that skull X-rays are u nnecessary. 78 patients (1.5 %) had a skull fracture and 41 patients ( 0.8 %) had suffered intracranial injuries. Of 57 patients with skull f ractures, 40 % (23) showed evidence of intracranial injury and 60 % (3 4) did not. Amongst 41 patients with intracranial injuries, 44 % (18) failed to show a skull fracture. Patients with a skull fracture (witho ut intracranial injury) showed just as many symptoms as patients witho ut skull fracture. Patients with intracranial injuries most commonly s howed neurological deficits, unconsciousness, or required intubation. Any one of these criteria or a combination of these indicated the pres ence of intracranial injury with a high degree of probability. These c riteria permit economy with skull X-rays and indicate when to use othe r diagnostic means (CT). For this the patient should be mentally quite normal. There should be a definite history and a reliable observation period of 24 hours.