ABSTRACT

Head traumas are among the most frequent reasons for pediatric emergency department visits and an important cause of mortality and morbidity. Computed tomography (CT) of the head is the standard method of diagnosing traumatic brain injury. However, the risk of radiation exposure and other possible risks associated with sedation that may be needed in some patients to perform CT should be taken into consideration. The aim of this study was to discuss the necessity of CT in children with minor head trauma.

Children aged 0-18 years, who were admitted to Adana Numune Training and Research Hospital Pediatric Emergency Department due to head trauma between January 2014 and December 2015, were retrospectively evaluated. Patients with head trauma who underwent CT and those with a Glasgow Coma Score of 14-15 were included in our study. Demographic features as well as CT results and surgical needs were evaluated.

A total of 342 patients were included in the study. The average age was 5.30±5.01 years. The causes of head trauma were traffic accidents in 12.6%, falling from height in 86.2, and others in 1.2% of patients. The number of patients with pathology detected by CT was 9 (2.6%). Fractures of the occipital bone were seen in 2 patients (0.58%), frontal bone fracture was detected in 5 patients (1.46%) and fracture of the parietal bone was observed in 1 patient (0.29%). Epidural bleeding was observed in one patient. 4 patients (1.16%) were hospitalized and monitored. Surgery was needed in one patient (0.29%) with epidural bleeding. No mortality occurred.

Studies on clinical decision rules for use of CT contribute to efforts to reduce the number of children undergoing unnecessary CT. This study revealed the fact that unnecessary CT in children with minor head trauma can be reduced by right indication and taking into the account the risks and benefits of CT Studies determining comprehensive and objective criteria are needed.

Keywords: Brain computed tomography, child, head trauma