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Can an abnormal CT scan be predicted from common symptoms after mild head injury in children?
Ashok Munivenkatappa1, Akhil Deepika1, Vasuki Prathyusha2
1Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
Insights
Predicting CT scan findings in children with mild head injury (MHI) is challenging. Symptoms alone do not reliably rule out abnormal CT scans, suggesting a liberal approach is advisable.
Area of Science:
- Pediatric Emergency Medicine
- Neuroradiology
Background:
- Mild head injury (MHI) in children often presents with non-specific symptoms.
- Identifying the need for computed tomography (CT) scans in these cases is clinically difficult.
Purpose of the Study:
- To identify predictors of CT scan findings in children following MHI.
- To improve diagnostic accuracy and clinical decision-making for CT scans in pediatric head trauma.
Main Methods:
- Retrospective evaluation of 133 children aged ≤12 years with Glasgow Coma Scale (GCS) scores of 13-15 after head injury.
- Analysis of clinical variables including age, gender, injury mechanism, loss of consciousness, vomiting, epistaxis, otorrhagia, and seizure.
Main Results:
- Over half (51.9%) of the children exhibited abnormal CT scan findings.
- No statistically significant differences were found in the evaluated clinical variables between patients with normal and abnormal CT scans.
Conclusions:
- Clinical symptoms alone are insufficient to reliably exclude abnormal CT scan findings in pediatric MHI.
- A liberal CT scan policy guided by clinical judgment is recommended for children with MHI.
Introduction:
Children have non specific symptoms after mild head injury (MHI). It is difficult to define indication of CT scan among them. We aimed at identification of predictors of CT scan findings after MHI.
Materials And Methods:
Children aged ≤12 years with GCS 13-15 after head injury were retrospectively evaluated for their clinical and CT scan findings during January to March 2010. The variables used for detection of abnormal (positive) CT scan were age, gender, cause of injury (road traffic accident, fall, and assault), loss of consciousness, vomiting, ear or nose bleed, seizure, and GCS score.
Results:
A total of 133 children were included in study. Sixty nine (51.9%) children had abnormal CT findings. There was no statistical difference in patients with normal vs abnormal CT scan for presence of any of the variables evaluated.
Conclusion:
An abnormal CT scan cannot be reliably ruled out in a child with MHI based on symptoms; hence a policy of liberal CT scan based on clinical acumen is advisable.
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