ToolsCalculators
Infant Scalp Score
Stratifies risk of traumatic brain injury in infants with an isolated scalp hematoma.
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.