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[Relevance of CT-scans for pediatric head injuries]
B Maier1, A Maier-Hemming, M Lehnert
1Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Zentrum der Chirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt.
Insights
Cranial CT scans are not always necessary for children with mild head injuries, even with symptoms like vomiting. However, severe head injuries in pediatric patients warrant immediate CT scans and hospitalization for proper treatment.
Area of Science:
- Pediatric Traumatology
- Neuroradiology
- Emergency Medicine
Background:
- Clinical evaluation of pediatric head injury presents diagnostic challenges.
- Cranial computed tomography (CT) scans are frequently utilized in assessing head injuries.
Purpose of the Study:
- To investigate the clinical relevance of cranial CT scans in pediatric head injury.
- To correlate CT findings with therapeutic outcomes in children.
Main Methods:
- Retrospective evaluation of pediatric head injury cases over a 5-year period.
- Analysis of X-ray and cranial CT scan results against clinical assessment and injury severity.
Main Results:
- In mild head injury (GCS 15-13), CT scans revealed few pathological findings, none requiring neurosurgery.
- Severe head injury (GCS <12) cases showed a higher incidence of intracranial bleeding and fractures.
Conclusions:
- Hospitalization is recommended for mild head injuries with loss of consciousness or vomiting; initial CT scans offered no therapeutic guidance.
- Immediate cranial CT and hospitalization are crucial for severe head injuries and polytrauma in children.
Aim Of The Study:
Clinical evaluation of pediatric head injury is quite difficult and often cranial CT scans are performed. We investigated the relevance of CT scans in relation to the therapeutic outcome.
Methods:
During a 5-year-period we retrospectively evaluated the results of x-ray and cranial CT scan in respect to primary clinical assessment and degree of head injury.
Results:
From 408 children classified as mild head injury (GCS 15-13) 217 received CT scans with 2 presenting pathological intracranial findings, none of these children required neurosurgical treatment. Out of 29 children suffering from severe head injury (GCS <12) 12 suffered from intracranial bleeding, and 17 had intracranial bleeding and a skull fracture.
Conclusion:
Children encountering mild head injury combined with primary loss of consciousness or vomiting, require hospitalisation. Initial CCT did not lead to therapeutic consequences in this group. Children classified as severe head injury or multiple traumatized children need immediate cranial CT scan and hospitalisation.