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Giora & all,
Enjoyed the thread and kudos to you for being the test minimizer! I particularly appreciate the prompt feedback you have given us. 

I thought Rob's suggestion from down under, was very reasonable.."no shock or horror!" Since the pre-CT probability of a
clinically significant ICH was small in this playful cherube, a screening radiograph may be a cost effective approach?  In fact, one can fail to detect a skull fx. on CT particularly if the slices are in the plane of the fracture. 

Rob you said, ".....presence of a fracture in this setting gives a 40 fold increase in need
for n-surgical intervention....if negative then it comes down to
demographic factors [admission versus discharge with sensible
parents/not late at night/no NAI flags/live nearby/doesn't live in the
medico-legally charged US ;-) etc] - interested in opinions"

Could you cite a reference for this 40 fold increase you mention? My readings were that the relative risk of ICH increases 4 fold in an infant with a skull fx. 
Thanks again,
Jay
 
Jay Pershad
Le Bonheur

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