| Teasdale GM et al, 1990, Glasgow | Sub group in paper of 99 head injured children requiring neurosurgery | Multicentred prospective comparative | Fully conscious and no skull fracture | 16% of those with ICI 0.5% of all attendees with head injury in this category | Incomplete data Not restricted to mild trauma |
| | | Impaired consciousness and no skull fracture | 12% of those with ICI 7.6% of all attendees in this category | |
| Dietrich AN et al, 1993, USA | All head trauma children scanned in 12 month period n=322, mean age of 7.1 years 20% <2 years old | Prospective cohort | CT results | 12% with ICI | Not restricted to mild trauma |
| | | Clinical factors | Amnesia for event highest sensitivity of 87%. LOC less sensitive at 68%. Abscence of amnesia, LOC, focal neurology and headache >89% negative predictive value | Not clear if all head trauma seen was scanned |
| | | | | Not clear if truly prospective |
| | | M & M | 5% of those with ICI had evacuation of haematoma. 13% died | Incomplete clinical data No available data on interventions required for those with minor head injury |
| Quayle KS et al, 1997, USA | 322 `non-trivial' head injuries | Prospective cohort | Imaging | 8.4% had ICI | 410 children originally identified as `non-trivial' |
| | | Surgical follow up | 59% (16) of those with ICI GCS of 15 and no focal neurology, 1 of whom required neurosurgery. 6 of these asymptomatic children were <1 year (5/6 had scalp haematoma). Four-fold increase of intracranial haematoma with skull fracture | Selective and incomplete data collection on subgroup |
| | | | | Not restricted to mild trauma |
| Greenes DS and Schutzman SA, 1999, USA | 608 infants <2 years (11.2 +/− 6.8 months. 57% male) with head trauma | Prospective (selected CT scan) | CT result | 16% of those imaged shown to have ICI | Real rate of ICI injury on CT probably underestimated as only 31% had CT following pre-existing ED protocol |
| | | Clinical factors in CT proven ICI | Half of those with ICI had no symptoms. Significantly more ICI in infants <3 months | |
| | | Age | 93% of infants who were asymptomatic with ICI had scalp haematoma (77% of those with ICI overall) | GCS not given |
| | | | | Not restricted to minor injury |
| | | Scalp haematoma | 13% of infants with ICI had evacuation of haematoma | |
| | | M & M | No deaths | |
| | | Two week follow up | No CT's ordered for those not imaged originally, no clinical deterioration for those who had a normal CT originally | |
| Wang MY et al, 2000, USA | 157 of 209 children with GCS of 13–14 as assessed by paramedic at scene transported to trauma centre and were CT scanned | Prospective multicentre | Head CT | 19.1% had ICI, half of whom had no skull fracture | Data not available for 52 patients |
| | | Difference in GCS | No significant difference in ICI or skull fracture between GCS 13 and 14 | No data on focal neurology |
| | | Change in GCS | 60% of those with ICI had an improvement in GCS on re-examination (ie >13) | |
| | | Loss of consciousness | 67% of those with ICI had no history of LOC | |
| | | M & M | 3.2% had haematoma evacuation, one of whom required long term rehabilitation. All lived | |