How long do we need to observe head injuries in hospital?

observation after an injury to the head. Only 22 of 35 who subsequently developed intracranial haemorrhage, presented for examination within 24 hours of the injury. All of these patients had symptoms or signs clearly needing continued observation or treatment six hours after the injury. Many children who are currently admitted to hospital could safely be discharged after a limited period of observation. Head injuries account for a considerable proportion of all paediatric admissions to hospital.'-3 These children are admitted to hospital because of concern that they may develop delayed, treatable complica-tions from their injury, of which the most common is intracranial haemorrhage.4 5 Most children admit-ted with head injuries recover quickly and, in retrospect, admission is shown to be unnecessary. Hospital admission may be emotionally disturbing to the child and is expensive.6 The large number of children admitted with no subsequent sequelae may lull doctors into a false sense of security, however, and these doctors may then discharge patients who deserve observation.7 This study was instigated to help in the clinical evaluation of children presenting for medical atten-tion after head injury and to assess the current effectiveness of the policy of admitting these chil-dren for 24 hours ' observation in hospital