HOW IMPORTANT IS SCALP SOFT-TISSUE INJURY AS A PREDICTOR OF SKULL FRACTURE

The assessment and management of the 'minor head injury' is fraught with pitfalls. The present guidelines for determining the need for skull X-rays are, unfortunately, somewhat ambiguous, open to wide variations in interpretation, and relatively non-specific. In a 6-month period from August 1989 to January 1990, three cases of 'minor head injury' were encountered, in whom X-rays were initially thought to be unnecessary on clinical grounds. In two of these patients the outcome was eventually fatal. The purpose of presenting these cases is to ascertain the relevance of scalp injury as a marker of skull fracture.