Tunturi T, Nieminen R, Pätiälä H, Rokkanen P, Tammilehto L, Turunen M, Lehtinen E, Seppänen S
Injury. 1982 May;13(6):478-83. doi: 10.1016/0020-1383(82)90162-0.
Five hundred and ninety-eight cases were studied where the patients had been subjected to skull radiography because of a head injury. Concussion had been established in 231 patients and a more severe brain injury in 8. Forty-nine patients (8.2 per cent) had skull fractures. The relative frequency of fractures was the highest among those aged between 40 and 59 years (16 per cent). From among 16 variables, either clinical or pertaining to the history, 4 had clearly sustained a fracture of the skull, the statistically significant features being amnesia, unconsciousness for over 30 minutes, a wound and subcutaneous haematoma in the scalp and a reduced level of consciousness. On the basis of these signs the patients could be divided into two groups which differed in the frequency of skull fractures by a factor of five. The skull fracture was not observed to have influenced the patient's care or recovery, particularly if the patient had a concurrent brain injury. Based on the results, the indications for skull radiography in patients with head injuries can be identified and this can reduce the need for X-ray examinations to one-half and still reveal 80 per cent of skull fractures.
对598例因头部受伤接受颅骨X线摄影的患者进行了研究。其中231例被诊断为脑震荡，8例为更严重的脑损伤。49例（8.2%）患者发生颅骨骨折。骨折相对发生率在40至59岁年龄组中最高（16%）。在16项临床或病史相关变量中，有4项明显提示颅骨骨折，具有统计学意义的特征为失忆、昏迷超过30分钟、头皮伤口及皮下血肿和意识水平降低。根据这些体征，患者可分为两组，颅骨骨折发生率相差5倍。未观察到颅骨骨折对患者的治疗或康复产生影响，尤其是在患者同时存在脑损伤的情况下。根据研究结果，可以确定头部受伤患者颅骨X线摄影的指征，这可将X线检查需求减少一半，同时仍能发现80%的颅骨骨折。
