[Minor head trauma in children: clinical surveillance or systematic computerized tomography?]

In children, minor head trauma is a common injury that can result in intra cranial injury. The 6th "Conférence de consensus en réanimation et médecine d'urgence" in 1990, then the American Academy of Pediatrics in 1999, published clear guidelines for management of head injured children older than 2 years, specially regarding X-ray imaging, while currently no clear guidelines exist regarding children younger than 2 years. Being at higher risk for injuries and more difficult to assess, many authors recommend for these young children a low threshold for X-ray imaging. However we believe that many asymptomatic infants older than 3 months of age who have no significant scalp hematoma, no high force mechanism of injury, and no suspicion of child abuse, can be safely managed without X-ray imaging.