A cohort retrospective study on computed tomography scan among pediatric minor head trauma patients

Abstract

Objectives: Computed tomography (CT) scan is commonly performed in head trauma patients to identify severity of the brain injury. However, the role of clinical signs and consciousness is critical in deciding the need of CT scan, in order to avoid unnecessary exposure to X-ray radiations. The aim of this study was to evaluate the incidence of positive CT findings in our pediatric population referred to our center with minor head trauma and its correlation with clinical signs and symptoms. Method: In this retrospective study, children aged under 15 years presented to our center within 6 h of minor head trauma from 2019 to 2020 were included. CT findings, demographic data, Glasgow Coma Scale (GCS) and clinical sign were extracted from patient data file. Positive CT scan patients were further evaluated in terms of GCS and signs and symptoms. The data were analyzed using SPSS v25. Result: Of 380 children included, the most common findings from CT scan were fractures (11.8%), SAH (subarachnoid hemorrhage) (6.1%), and ICH (intracerebral hemorrhage) (5.5%). 18.7% of total children had positive CT findings. Nausea and vomiting, seizure, racoon eyes, battle sign and GCS less than 15 were positively associated with positive CT finding. Mechanism of trauma and age group were not associated with positive CT. Conclusions: Clinical signs should be observed among the patients along with level of consciousness before CT scan. Further studies are required to design a precise algorithm and guidelines regarding the use of CT scan among pediatric minor head trauma patients. Highlights

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