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Infant Scalp Score of Schutzman et al

Description

Schutzman et al reported the Infant Scalp Score to evaluate an infant with an isolated scalp hematoma. This can help to identify an infant with traumatic brain injury (TBI) on imaging studies. The authors are from Boston Children's Hospital and Harvard Medical School.


Patient selection: infant with isolated scalp hematoma not due to physical abuse

 

Parameters:

(1) age in months

(2) hematoma size

(3) hematoma location

 

Parameter

Finding

Points

age in months

0 to 2 months

3

 

3 to 5 months

2

 

6 to 11 months

1

 

>= 12 months

0

hematoma size

none

0

 

small (barely palpable or < 1 cm in diameter)

1

 

medium (1 to 3 cm)

2

 

large (> 3 cm in diameter)

3

hematoma location

frontal

0

 

occipital

1

 

temporal

2

 

parietal

2

 

total score =

= SUM(parameters for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 8

• All infants with a scalp hematoma and a score < 4 were free of traumatic brain injury on imaging studies.

• All infants with a scalp hematoma and a score < 5 were free of clinically significant brain injury.

 

Score

Any TBI

Clinically Significant

4

1%

0%

5

4%

1%

6

17%

2.6%

7

25%

5.5%

8

43%

22%

 

Performance:

• The area under the ROC curve for traumatic brain injury was 0.81.

• The area under the ROC curve for clinically significant traumatic brain injury was 0.92.


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