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 Dr 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. 117 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.