Vomiting Is a Poor Predictor of Intracranial Injury in Pediatric Head Trauma

In a secondary analysis of patients presenting with blunt head trauma to centers in the Pediatric Emergency Care Applied Research Network (PECARN), investigators evaluated whether isolated vomiting is a predictor of intracranial injuries. Isolated vomiting was defined two ways: (1) vomiting in a patient acting normally and without loss of consciousness, altered mental status, skull fracture, scalp trauma, headache, seizure, neurologic deficits, or amnesia (extensive definition); (2) vomiting in the absence of all other criteria of the PECARN head injury rules (NEJM JW Emerg Med Sep 25 2009). Clinically important brain injury was defined as injury resulting in death, a neurosurgical procedure, intubation, or hospitalization for two or more n…