Leidel B A, Lindner T, Wolf S, Bogner V, Steinbeck A, Börner N, Peiser C, Audebert H J, Biberthaler P, Kanz K-G
Interdisziplinäre Rettungsstelle, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland,
Med Klin Intensivmed Notfmed. 2015 Jun;110(5):379-94; quiz 395-6. doi: 10.1007/s00063-015-0047-6.
Mild head injuries are one of the most frequent reasons for attending emergency departments and are particularly challenging in different ways. While clinically important injuries are infrequent, delayed or missed injuries may lead to fatal consequences. The initial mostly inconspicuous appearance may not reflect the degree of intracranial injury and computed tomography (CT) is necessary to rule out covert injuries. Furthermore, infants and young children with a lack of or rudimentary cognitive and language development are challenging, especially for those examiners not familiar with pediatric care. Established check lists of clinical risk factors for children and adults regarding traumatic brain injuries allow specific and rational decision-making for cranial CT imaging. Clinically important intracranial injuries can be reliably detected and unnecessary radiation exposure avoided at the same time.
轻度头部损伤是急诊就诊的最常见原因之一，并且在多方面具有特殊挑战性。虽然具有临床意义的损伤并不常见，但延迟或漏诊的损伤可能导致致命后果。最初大多不明显的表现可能无法反映颅内损伤程度，因此需要进行计算机断层扫描（CT）以排除隐匿性损伤。此外，认知和语言发育不足或不完善的婴幼儿具有挑战性，对于那些不熟悉儿科护理的检查人员来说尤其如此。针对儿童和成人创伤性脑损伤的既定临床风险因素检查表有助于对头颅CT成像做出具体且合理的决策。这样既能可靠地检测出具有临床意义的颅内损伤，又能避免不必要的辐射暴露。
