Pediatric minor head trauma

Schutzman, Sara A.; Greenes, David S.

doi:10.1067/mem.2001.109440

Cited by 196 publications

(158 citation statements)

References 94 publications

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“…2 The gold standard diagnostic test to evaluate for skull fracture and intracranial hemorrhage is head computed tomography (CT), which is highly sensitive for identification of children with intracranial injuries requiring acute intervention. 3 However, CT imaging exposes developing brains to ionizing radiation [4][5][6][7] and may require sedation in young children. Clinicians caring for children need to decide, on the basis of the risks and benefits, whether to perform a head CT in a child presenting with a closed head injury.…”

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confidence: 99%

Accuracy of Point-of-Care Ultrasound for Diagnosis of Skull Fractures in Children

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Head injuries and concern for skull fracture are common in pediatrics. Point-of-care ultrasound is an imaging tool that can be used to diagnose fractures. However, there are scant data regarding the accuracy of point-ofcare ultrasound in skull fracture diagnosis. WHAT THIS STUDY ADDS:Clinicians with focused point-of-care ultrasound training are able to diagnose skull fractures in children with high specificity. Ultrasound may be valuable to diagnose skull fractures in children at the point of care. abstract OBJECTIVE: To determine the test performance characteristics for point-of-care ultrasound performed by clinicians compared with computed tomography (CT) diagnosis of skull fractures. METHODS:We conducted a prospective study in a convenience sample of patients #21 years of age who presented to the emergency department with head injuries or suspected skull fractures that required CT scan evaluation. After a 1-hour, focused ultrasound training session, clinicians performed ultrasound examinations to evaluate patients for skull fractures. CT scan interpretations by attending radiologists were the reference standard for this study. Pointof-care ultrasound scans were reviewed by an experienced sonologist to evaluate interobserver agreement.RESULTS: Point-of-care ultrasound was performed by 17 clinicians in 69 subjects with suspected skull fractures. The patients' mean age was 6.4 years (SD: 6.2 years), and 65% of patients were male. The prevalence of fracture was 12% (n = 8). Point-of-care ultrasound for skull fracture had a sensitivity of 88% (95% confidence interval [CI]: 53%-98%), a specificity of 97% (95% CI: 89%-99%), a positive likelihood ratio of 27 (95% CI: 7-107), and a negative likelihood ratio of 0.13 (95% CI: 0.02-0.81). The only false-negative ultrasound scan was due to a skull fracture not directly under a scalp hematoma, but rather adjacent to it. The k for interobserver agreement was 0.86 (95% CI: 0.67-1.0). CONCLUSIONS:Clinicians with focused ultrasound training were able to diagnose skull fractures in children with high specificity. Pediatrics

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confidence: 99%

Accuracy of Point-of-Care Ultrasound for Diagnosis of Skull Fractures in Children

et al. 2013

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“…1 A incidência de casos nos Estados Unidos é de 600.000 atendimentos por ano em departamentos de emergência, 95.000 internações e 7.000 óbitos. 2 Em sua maioria, os casos de TCE em unidades de emergência são leves, porém podem causar lesões graves. 2 As principais causas de TCE leve na infância são motivadas por quedas de própria altura, seguidas por quedas de bicicleta e acidentes de trânsito.…”

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“…2 Em sua maioria, os casos de TCE em unidades de emergência são leves, porém podem causar lesões graves. 2 As principais causas de TCE leve na infância são motivadas por quedas de própria altura, seguidas por quedas de bicicleta e acidentes de trânsito. [3][4][5] No TCE leve, apenas um número reduzido de casos requer exames de imagens.…”

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2013

Arq Bras Neurocir

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“…2 As for any given case of suspected head injury, the CT scan is the investigation of choice to investigate a case of suspected posterior fossa fracture. 7 We need to remember that the posterior fossa is a crowded space and has a relatively small volume and hence any lesion has the potential to further reduce its volume leading to rise in intracavitary pressure. 6 Most of the patients with posterior fossa depressed fractures can be managed conservatively.…”

Section: Pajtmentioning

confidence: 99%

Depressed Fracture Involving the Posterior Fossa in a Child

2015

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Pediatric minor head trauma

Cited by 196 publications

References 94 publications

Accuracy of Point-of-Care Ultrasound for Diagnosis of Skull Fractures in Children

Accuracy of Point-of-Care Ultrasound for Diagnosis of Skull Fractures in Children

Untitled

Depressed Fracture Involving the Posterior Fossa in a Child

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