RESUMEN
The generally accepted definition of minor head injury includes Glasgow Coma Scale [GCS] scores of 13 to 15. However, many studies have shown that there is a heterogeneous pathophysiology among patients with GCS scores in this range. To assess the risk of a significant intracranial neurosurgical and neurological complication after apparently minor head injury, the authors collected data prospectively on 950 patients who had sustained a transient posttraumatic loss of consciousness or other neurological function and who had a Glasgow Coma Scale [GCS] scores of 13, 14, or 15 in the emergency room. This study is based on 950 consecutive patients admitted to El Hossin and Sayed Galal University Hospitals during the 14-month period beginning in April, 1996, and ending in May, 1997. Skull x-ray films and/ or CT scans were obtained in all patients in this study. Abnormal radiographic findings were defined as the following: 1] skull fracture [including depressed skull fracture]; 2] intracranial hematoma or contusion; and 3] traumatic subarachnoid hemorrhage. After evaluation in the emergency room, 538 [51.1%] patients were admitted and staying in the hospital. Some of these patients had relatively uncomplicated injuries that required neurological observation while other patients required a neurosurgical procedure. Neurosurgical interventions were defined as placement of an craniotomy for evacuation of a clot. Operative procedures were required in the 48 patients with minor head injury; there are 12 patients had depressed skull fractures, 14 patients had acute epidural hematoma and 22 patients had burr holes for chronic subdural hematoma. The results of this study showed that patients with lower GCS scores tended to have suffered more serious injury