Pediatric Basilar Skull Fracture: Do Children With Normal Neurologic Findings and No Intracranial Injury Require Hospitalization?, ,

Study objective: To delineate complications in patients with basilar skull fractures (BSFs) and normal neurologic findings, including computed tomography (CT) scans without intracranial injury, and to assess the need for hospitalization. Design: Retrospective chart review. Participants: All emergency department patients with the ED diagnosis or hospital discharge diagnosis of BSF. Patients were included if they had a clinical or radiographic diagnosis of BSF. A subgroup of patients ("simple BSF") with normal neurologic examination findings in the ED, Glasgow Coma Scale scores of 15, and cranial CT scans without intracranial pathology was specifically analyzed. Results: We included 239 patients in the study. One hundred fourteen patients (48%) were included in the "simple BSF" subgroup. In this subgroup, vomiting (6%) was the most common complication, meningitis (1%) the most serious. There were no cases of delayed intracranial hemorrhage, and no patient with "simple BSF" required surgery. Conclusion: Given the relatively low frequency of serious complications, our study suggests that some patients with BSFs may not require hospital admission. [Kadish HA, Schunk JE: Pediatric basilar skull fracture: Do children with normal neurologic findings and no intracranial injury require hospitalization? Ann Emerg Med July 1995;26:37-41.]