Do Children With Blunt Head Trauma and Normal Cranial Computed Tomography Scan Results Require Hospitalization for Neurologic Observation?

Holmes, James F.; Borgialli, Dominic; Nadel, Frances M.; Quayle, Kimberly S.; Schambam, Neil; Cooper, Arthur; Schunk, Jeff E.; Miskin, Michelle; Atabaki, Shireen M.; Hoyle, John D.; Dayan, Peter; Kuppermann, Nathan

doi:10.1016/j.annemergmed.2011.03.060

Cited by 58 publications

(45 citation statements)

References 17 publications

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“…Holmes et al stated that among children with a normal cranial CT scan after minor head trauma, delayed intracranial sequelae requiring intervention are extremely uncommon [9]. In our study, we also see that none of the children had an increased pathological condition in the 2nd CT scan.…”

Section: Discussionsupporting

confidence: 68%

Analysis of Repeated CT Scan Need in Blunt Head Trauma

Eroğlu

Onur

Ozkaya

et al. 2013

Emergency Medicine International

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Background. Computed tomography (CT) is a vital tool in the workup of patients with closed head trauma. The aim of this study was to investigate the necessity of serial CT scans in patients with blunt head trauma. Methods. This is a retrospective study analyzing trauma patients between January and June 2012. Data were analysed by using frequencies, Kolmogorov-Smirnov (K-S), and Chi-square tests. Results. Of the total 351 control Head CTs, it was seen there were no different in 346 (98.6%). In CTs of another 3 patients (0.9%), there were increasing or new, in the other 2 (0.6%) there was a decrease in the pathology present. Of 24 (6.8%) patients who had a hemorrhage in the first CT, there was an increase in the hemorrhage in one of them, a decrease of the pathology in 2 of them. Of 27 (7.7%) patients who had fracture in first CT, 2 had a new intracranial hemorrhage. The relation of the results between the first and second CTs were statistically significant (P < 0.001, χ 2 test). Conclusion. Repeated CT scans after 6 hours in EDs observation rooms are not necessary if first CT is normal in most situations. Special attention may be needed in patients with an underlying chronic disease.

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Section: Discussionsupporting

confidence: 68%

Analysis of Repeated CT Scan Need in Blunt Head Trauma

Eroğlu

Onur

Ozkaya

et al. 2013

Emergency Medicine International

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“…Thus, there was a 100% negative predictive value for neurosurgical intervention in children who presented with a normal neurologic examination result and a normal head CT scan result after sustaining blunt trauma. 13 In our study, none of the young children sustaining an SF who presented with a normal neurologic examination result (GCS score, 15) developed any neurologic deficit. Action to reduce unnecessary admissions in the pediatric population will undoubtedly contribute to improved public health because resources will not be needlessly allocated to a population at negligible risk for serious negative health outcomes.…”

Section: Discussionmentioning

confidence: 92%

Natural history and clinical implications of nondepressed skull fracture in young children

Hassan

Cohn

Admire

et al. 2014

Journal of Trauma and Acute Care Surgery

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“…[5] On the other hand, children with normal CT scan after MHI can be discharged, and hospitalization is generally unnecessary. [6] However, CT scan is not advisable for all children because of a remote risk of cancer. [7] In a recent study on cancer due to CT scan, the authors found that the use of CT scans in children to deliver cumulative doses of about 50 mGy (i.e.…”

Section: Discussionmentioning

confidence: 99%

Can an abnormal CT scan be predicted from common symptoms after mild head injury in children?

et al. 2013

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Introduction:Children have non specific symptoms after mild head injury (MHI). It is difficult to define indication of CT scan among them. We aimed at identification of predictors of CT scan findings after MHI.Materials and Methods:Children aged ≤12 years with GCS 13-15 after head injury were retrospectively evaluated for their clinical and CT scan findings during January to March 2010. The variables used for detection of abnormal (positive) CT scan were age, gender, cause of injury (road traffic accident, fall, and assault), loss of consciousness, vomiting, ear or nose bleed, seizure, and GCS score.Results:A total of 133 children were included in study. Sixty nine (51.9%) children had abnormal CT findings. There was no statistical difference in patients with normal vs abnormal CT scan for presence of any of the variables evaluated.Conclusion:An abnormal CT scan cannot be reliably ruled out in a child with MHI based on symptoms; hence a policy of liberal CT scan based on clinical acumen is advisable.

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Do Children With Blunt Head Trauma and Normal Cranial Computed Tomography Scan Results Require Hospitalization for Neurologic Observation?

Cited by 58 publications

References 17 publications

Analysis of Repeated CT Scan Need in Blunt Head Trauma

Analysis of Repeated CT Scan Need in Blunt Head Trauma

Natural history and clinical implications of nondepressed skull fracture in young children

Can an abnormal CT scan be predicted from common symptoms after mild head injury in children?

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