ToolsCalculators
Infant Scalp Score
Infant Scalp Score
Age
Hematoma size
Hematoma location
Result0 points (of 8)
Low risk of clinically important traumatic brain injury; imaging may not be necessary in an otherwise well-appearing infant.
When to use
- Infants with an isolated scalp hematoma after minor blunt head trauma and a normal neurological examination, to help decide between CT, observation, and discharge.
Formula
Infant Scalp Score (0-8) = points for age (0-2 mo=3, 3-5 mo=2, 6-11 mo=1, >12 mo=0) + hematoma size (large=3, medium=2, small=1, none=0) + hematoma location (temporal/parietal=2, occipital=1, frontal=0). A score ≥4 has been reported to have high sensitivity for clinically important TBI.
Pearls and pitfalls
- Applies only to infants with an isolated scalp hematoma and a reassuring history/exam — not validated for infants with other high-risk features.
- A higher cutoff (≥5) trades a small amount of sensitivity for improved specificity in some validation cohorts.