Post-traumatic vomiting-a predictor of severity of head injury

ABSTRACT

To determine whether post-traumatic vomiting can predict risk of a skull fracture in minor head injury patients. Design: A non-interventional study, carried out prospectively. Place and Duration of Study The Neurosurgical Centre, CMH Rawalpindi over a period of 06 months from November, 1999 to April, 2000. Subjects and All the patients of head injury presenting at our centre over a period of 06 months were included in our study. We collected the data related to a consecutive series of 142 head injury patients. Data included age, sex, mechanism of injury, level of consciousness on initial examination, incidence of skull fracture and the presence and frequency of post-traumatic vomiting.Radiographs of skull[AP, Lateral and Towne's view] were obtained for all the patients diagnosed as having a minor head injury [Glasgow Coma Score Scale 14-15]. Post-traumatic vomiting in patients with minor head injury was encountered in 36.23% adults and 65.85% children.In patients with a skull fracture, vomiting was encountered in 81.81% adults and76.92% children. Post-traumatic vomiting was associated with a significant [p=0.79] increase in the relative risk for a skull fracture. Conclusions: It was concluded that a question about vomiting should be included in the guidelines for skull radiography. Patients found to have a skull fracture can thus be admitted for neuro-observation and computed tomography if indicated