Risk factors for positive brain CT scan in children with traumatic brain injury and GCS = 15

Wang, Junyou; Hu, Yan; Wu, Panxing

doi:10.1097/md.0000000000024543

Cited by 4 publications

(5 citation statements)

References 29 publications

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“…Positive findings in CT scan were seen in 50% of the cases, with skull fracture being the predominant finding, followed by epidural hematoma (EDH) in a study. [ 11 ] This was similar to our CT scan results. Another study also observed similar results with EDH and fracture hematoma as common findings on neuroimaging.…”

Section: Discussionsupporting

confidence: 91%

“…The cases were predominantly males, as seen in other studies. [ 10 , 11 ] Road traffic accident (RTA) and fall from height formed the principal mechanism of head injury in our study. Similar observations were made in other studies [ 12 - 14 ] on head injury in pediatric patients.…”

Section: Discussionmentioning

confidence: 93%

“…Headache, scalp hematoma, and nausea with or without vomiting were the three main symptoms in one study. [ 11 ] In contrast, vomiting, LOC, and ear/nose bleeding were the chief symptoms in another study. [ 10 ]…”

Section: Discussionmentioning

confidence: 96%

“…Scalp hematoma, nausea with or without vomiting, and ear/ nose bleeds or soft-tissue contusion in the periorbital region were found to have independent association with abnormality on CT scan in children with mild traumatic brain injury and GCS of 15. [ 11 ] Absence of vomiting, headache, scalp hematoma, clinical signs suggestive of fracture of the skull, and abnormality in mental status identified children at low risk for traumatic brain injuries on CT scans following blunt head trauma in another study. [ 17 ] Differences in study settings and inclusion criteria are probably the reasons for this variance in the risk factors.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of clinical features with neuroimaging in children with mild head injury

Shenoy,

Patil,

Samaga

et al. 2023

JNRP

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Objectives: Mild head injury is defined as a pediatric Glasgow Coma Scale (GCS) score of 13–15 at admission following head trauma. There are no clear indications for neuroimaging in such children. The aim of our study was to analyze the correlation of symptoms commonly encountered following mild head injury with any abnormality on the computed tomography (CT) scan. Materials and Methods: This is a retrospective and observational study done in a tertiary care hospital. Records of all the children fulfilling the inclusion criteria were retrieved. Demographic details such as age, gender, and type of injury (hit by a blunt object, fall from height, and road traffic accident), symptoms such as presence and number of episodes of vomiting, presence and duration of loss of consciousness (LOC), presence of drowsiness, headache, giddiness, seizures, focal deficits and the GCS score, and CT scan findings were noted in a predesigned proforma. A CT scan with any of the following abnormalities such as skull fracture, cerebral edema, intracranial bleed (epidural hematoma, subdural hematoma, intracerebral hematoma, and subarachnoid hemorrhage), and cerebral contusion was considered as abnormal. Any neurosurgical intervention done was also noted. Results: A total of 134 children in the age group of 1 month to 18 years with mild head injury were included in this study. The median (interquartile range) age of the children was 5 (2, 8) years, with majority being males. Road traffic accidents (34.3%) were the most common cause of injury, followed by fall from lesser than 3 feet height (31.3%). The most common symptoms were vomiting (43.6%), scalp/facial abrasions (37.2%), and LOC (31.9%). CT scan was abnormal in 53.7% of the cases, with skull fracture (35.1%) being the most common finding, followed by cerebral edema (13.4%). Among all the symptoms, ear/nosebleed or cerebrospinal fluid (CSF) otorrhea/rhinorrhea had a statistically significant association with a positive CT scan with P = 0.05 and an odds ratio of 1.4 (95% confidence interval, 1–1.9). Conclusion: Children with mild head injury presenting with clinical features such as bleeding from the ear or nose and CSF otorrhea/rhinorrhea are more likely to have an abnormal CT scan. Hence, such children require close neurological observation and prompt intervention if necessary. However, abnormality on CT scan cannot be reliably ruled out based on the symptoms alone.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Correlation of clinical features with neuroimaging in children with mild head injury

Shenoy,

Patil,

Samaga

et al. 2023

JNRP

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“…A study by Kirschen et. involved 344 patients, of which 36 (10.5%) had a hematoma on CT examination and according to Wang et al hematomas were seen in 17.6% patients [35,36]. In comparison to those results, in the study 36 out of 136 (26.47%) patients among children with head CT lesions were found to have hematoma, including 30 boys, for whom hematoma was also the most common traumatic lesion (7.8%).…”

Section: Hematomamentioning

confidence: 61%

comparison of pathological findings in head computed to-mography with clinical presentation of pediatric patients in the Emergency Department

Lipiński

Lipińska

Kopeć

et al. 2023

J Educ Health Sport

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Pediatric trauma is a cause for over 750.000 visits to emergency departments each year. Of all types of traumas, head injuries represent the group at most risk. Computed tomography (CT) is still the most frequently used advanced imaging method to distinguish cases of severe injuries out of thousands of mild or apparently trivial injuries. The aim of this study was to review the results of CT in terms of clinical prediagnosis and radiological findings in children categorized into four age groups, who underwent a CT scan in the Pediatric Emergency Department (ED). Among all CT studies, no findings were found in 552 (80.23%) patients, whereas CT findings were detected in 98 (14.2%) boys and 38 (5.5%) girls from all participants. The incidence of lesions in the male group is 2 times higher than in the female group. The most common abnormality was hematoma representing 26.47% of all confirmed lesions and 5.23% among all head CTs performed from the ED. Head CT is an incredibly useful tool in the evaluation of some head emergencies. However, in the majority of cases, the clinical presentation with which children present to the ED does not correlate with the severity of neuroimaging results.

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Point-of-care ultrasound diagnosis of skull fracture in Chinese children 0–6 years old with scalp hematoma from minor head trauma: A preliminary prospective observational study

Huang¹,

Huang²,

Liao³

et al. 2023

Heliyon

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Risk factors for positive brain CT scan in children with traumatic brain injury and GCS = 15

Cited by 4 publications

References 29 publications

Correlation of clinical features with neuroimaging in children with mild head injury

Correlation of clinical features with neuroimaging in children with mild head injury

comparison of pathological findings in head computed to-mography with clinical presentation of pediatric patients in the Emergency Department

Point-of-care ultrasound diagnosis of skull fracture in Chinese children 0–6 years old with scalp hematoma from minor head trauma: A preliminary prospective observational study

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