How necessary is computed tomography in pediatric minor head trauma?

ABSTRACT Computerized tomography (CT) is very often used for head injury. Especially in child¬hood as related to the use of CT is known that a number of drawbacks. At the age of fifteen and under with minor head trauma, it is very difficult to assess whether CT is necessary. The purpose of this study was to assess the necessarity of CT in children who are at 15 years of age and under with minor head trauma. The records of 115 cases who applied with minor head trauma between October 2010-June 2011 to Nevşehir State Hos¬pital Emergency Department, were examined retrospectively. Cases who are 15 years of age and under, with a score of Glascow Coma Scale 15, with a normal neurological examination and applied to emergency service after falls (falls from height, falling from a bicycle, falling on leisure activities), motor vehicle accident, crash and assault were included to study. Forty three (37.4%) were female and 72 (62.6%) were male, while the average age was 7. Among the symptoms, vomiting was the most frequent with 30.4%, while headache was in second place with 19.1%. When we look at the findings, soft tissue swelling was 29.6% in the first place. In all cases CT was taken. Ninety seven (84.4%) patients had normal CTs, while 18 (15.6%) patients had pathology in cranial CT. In cases with pathological cranial CT, 11 (61.1%) patients had linear fracture, 5 (27.7%) patients had depressed fractures, 1 (5.5%) patient had subdural hematoma plus linear fracture and 1 (5.5%) patient had plastering epidural hematoma. In these patients with pathologic cranial CT, 5 (27.7%) of them, (overall 4.3%) underwent surgery. In this study 29.4% of all patients with soft tissue swelling, and 83.3% of all patient with deep incision had pathological cranial CT. There were statistically significant difference between presence of soft tissue swelling, deep incision and pathological cranial CT. (Respectively p = 0.009 and p = 0.001). In children 15 years age and under with minor head trauma, cranial CT should be taken in the presence of soft tissue swelling and deep incision in physical ex¬amination. J. Exp. Clin. Med., 2011; 28:107-110
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