The Relationship between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head Trauma Admitted to Hospital

Abstract

BACKGROUND:In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan.AIMS:The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional.METHODS:We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years. Patient’s CT scan findings and head trauma risk factors were evaluated in this study.RESULTS:Out of 368 patients, 326 patients had normal brain CT scan. 28 of them showed symptoms of ICI consisting intraventricular haemorrhage (IVH), contusion, subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural hematoma (EDH), and pneumocephalus. Twenty-seven patients showed skull FX, which 14 of them had an Isolated fracture, and 13 of them also showed symptoms of ICI. Since patients with isolated FX usually discharge quickly from Emergency Department; their data did not include in results of the study. The patients have been divided into two groups: 1- ICI, 2- without ICI. RR (relative risk), CI (Confidence interval) and sensitivity, positive predictive value (PPV), negative predictive value (NPV) and association of these risk factors with ICI were assessed with the Chi-2 test. In the end to determine the indications of CT scan, the presence of one of these five risk factors is important including abnormal mental status, clinical symptoms of skull FX, history of vomiting, craniofacial soft tissue injury (including subgaleal hematomas or laceration) and headache.CONCLUSIONS:For all other patients without these risk factors, observation and Follow Up can be used which has more advantages and less cost.

The Frequency of Brain CT-Scan Findings in Patients with Scalp Lacerations Following Mild Traumatic Brain Injury; A Cross-Sectional Study

“…Thus we recommend performing brain CT scans in patients with mild TBI and scalp lacerations as the risk of intracranial pathologies in these patients is approximately high. This is in concordance with previous reports [6,8,11]. However, the role CT scan in evaluating the outcome of the patients with mild TBI has been a debate.…”

“…However, it has been demonstrated that there is no correlation with the clinical findings and the CT-scan findings in mild TBI especially in children [11]. The correlation between the scalp lacerations and the intracranial findings is yet to be investigated.…”

Effects of COVID-19 Isolation Practices on Neurosurgical Traumas

“…It is known that men are more involved in business life than women. 2,4,8,9,12 Although the rate of males was higher before and after the pandemic in our study, no statistically significant difference was found between the genders (Table 1). We think this difference does not exist as all genders stay at home as active life is restricted due to Covid-19 isolation.…”

Effect of parental pressure on emergency physicians for computerized tomography imaging request in children with head trauma

“…The incidence of intracranial pathologies in children with head trauma was found to be b10% in most studies [5,7,18]. Although these pathologies vary from isolated skull fractures to epidural hematomas, the frequency of neurosurgical operation requirement is b1% [5].…”