Characteristics of children with vomiting after minor head trauma: a case-control study

OBJECTIVE: To study selected factors associated with vomiting after minor head trauma in children. STUDY DESIGN: During a 1-year study, 1097 children with a minor head injury were consecutively discharged from the pediatric emergency department; 162 had associated vomiting. A case-control study was conducted, with each subject matched with 2 children of the same age group with a minor head injury who did not have associated vomiting. Final analysis was conducted in 148 case subjects and 296 matched control subjects. RESULTS: With univariate analysis, a personal history of recurrent headache (6.1% versus 2.4%), motion sickness (27% versus 11.8%), and recurrent vomiting (6.1% versus 0.7%) were significantly more common in the vomiting group, as was a family history of recurrent headache in parents (45.9% versus 27%) or motion sickness in parents (26.4% versus 15.2%) or siblings (14.2% versus 3.7%). The strongest predictors of vomiting were a personal history of recurrent vomiting (odds ratio, 5.90; 95% CI, 1.18-29.47), motion sickness (odds ratio, 2.34; 95% CI, 1.32-4.10), headache at the time of the injury (odds ratio, 4.37; 95% CI, 2.23-8.57), and a strong family history of the same recurrent problems (odds ratio, 1.66; 95% CI, 1.29-2.13). CONCLUSIONS: Post-traumatic vomiting is significantly related to personal or familial predisposition to vomit rather than to the presence of intracranial lesions.