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Incidental findings on computed tomography scans in children with mild head trauma
Henry W Ortega1, Heidi Vander Velden, Samuel Reid
1Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA. henry.ortega@childrensmn.org
Insights
Incidental findings are common in pediatric head trauma CT scans, especially sinus opacification. Younger children with these findings often require antibiotics or specialist referrals.
Area of Science:
- Pediatric Radiology
- Emergency Medicine
- Neurotrauma
Background:
- Computed tomography (CT) scans are a standard diagnostic tool for pediatric traumatic brain injuries.
- Assessing incidental findings on these scans is crucial for comprehensive patient management.
Purpose of the Study:
- To evaluate the frequency and types of incidental findings in children undergoing head CT for trauma.
- To describe the clinical outcomes and management of these incidental findings.
Main Methods:
- A retrospective review was conducted on 524 children with closed head injuries treated in emergency departments.
- Data included CT scan results and subsequent clinical interventions.
Main Results:
- Incidental findings were present in 26.2% of pediatric patients.
- Sinus opacification with air-fluid levels was the most frequent incidental finding (83.9%).
- Younger children (≤2 years) with incidental findings had higher rates of antibiotic prescriptions and specialist referrals.
Conclusions:
- Incidental findings on head CT scans for minor pediatric head trauma are frequent.
- Clinicians must be prepared to manage these findings when clinically warranted.
Background:
Computed tomography (CT) scans are frequently used in managing traumatic brain injuries in children.
Objective:
To assess incidental findings in children with head trauma undergoing CT scan and to describe any associated clinical ramifications.
Materials And Methods:
Retrospective review of 524 children treated in 2 emergency departments for closed head injury who received a CT scan.
Results:
Overall, 137 (26.2%) patients had an incidental finding on CT scan. The most common incidental finding was sinus opacification with an air fluid level (115/137, 83.9%). Thirty-five interventions were reported in children with incidental findings. Children 2 years old or younger were more likely to receive a prescription for antibiotics (relative risk [RR] = 2.66, 95% confidence interval [CI] = 1.08-6.51) and be referred to a specialist (RR = 10.26, 95% CI = 3.56-29.56) than older children.
Conclusion:
Incidental findings in minor head trauma are common. Clinicians should be prepared to address these findings if clinically indicated.
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