Predicting factors for abnormal brain computed tomography in children with minor head trauma
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Published on: April 11, 2025
Taraneh Naghibi1, Mina Rostami2, Behrad Jamali3
1Department of Anesthesiology and Critical Care Medicine, School of Medicine, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
Insights
Headache, decreased consciousness, and repetitive vomiting predict the need for brain CT in children with minor head trauma. These clinical findings aid in timely diagnosis of traumatic brain injury (TBI) and reduce unnecessary radiation exposure.
Area of Science:
- Pediatric Emergency Medicine
- Radiology
- Neurology
Background:
- Minor head trauma (MHT) management in children requires careful assessment for Traumatic Brain Injury (TBI).
- Cranial Computed Tomography (CT) scans carry radiation risks, especially in pediatric patients.
- Predicting the necessity of brain CT in children with MHT is crucial for appropriate care.
Purpose of the Study:
- To identify clinical findings that predict the need for brain CT in children with MHT.
- To improve the diagnostic accuracy for TBI in pediatric patients with minor head injuries.
- To reduce unnecessary radiation exposure from brain CT scans in children.
Main Methods:
- Prospective cohort study of 200 children (2-14 years) with MHT.
- Data collection on MHT-related clinical findings.
- Statistical analysis using Binary Logistic regression, Fisher's exact test, and independent samples t-test.
Main Results:
- Seven out of 200 children (3.5%) had positive brain CT results.
- Headache, decreased level of consciousness, and vomiting were identified as predicting factors for abnormal brain CT.
- The most common injury mechanism was falling from height.
Conclusions:
- Repetitive vomiting (≥2), headache, and decreased level of consciousness are significant predictors of abnormal brain CT in children with MHT.
- These findings can guide clinical decision-making regarding brain CT necessity.
- Early identification of TBI risk factors can optimize management and minimize radiation exposure.
Background:
Deciding whether a cranial Computed Tomography (CT) scan in a patient with minor head trauma (MHT) is necessary or not has always been challenging. Diagnosing Traumatic Brain Injury (TBI) is a fundamental part of MHT managing especially in children who are more vulnerable in terms of brain CT radiation consequences and TBI. Defining some indications to timely and efficiently predict the likelihood of TBI is necessary. Thus, we aimed to determine the impact of clinical findings to predict the need for brain CT in children with MHT.
Methods:
In a prospective cohort study, 200 children (2 to 14 years) with MHT were included from 2019 to 2020. The data of MHT-related clinical findings were gathered. The primary and secondary outcomes were defined as a positive brain CT and any TBI requiring neurosurgery intervention, respectively. In statistical analysis, we performed Binary Logistic regression analysis, Fisher's exact test and independent samples t-test using SPSS V.26.
Results:
The mean age of participants was 6.5 ± 3.06 years. Ninety patients underwent brain CT. The most common clinical finding and injury mechanism were headache and falling from height, respectively. The results of brain CTs were positive in seven patients (3.5%). We identified three predicting factors for an abnormal brain CT including headache, decreased level of consciousness, and vomiting.
Conclusion:
We showed that repetitive vomiting (≥2), headache, and decreased level of consciousness are predicting factors for an abnormal brain CT in children with MHT.
