Clinical criteria for head computed tomography in children with mild head injury

Karolina Rosołowicz, Paula Wolan, Aleksandra Puciło, Jacek Materny, Elżbieta Gawrych



Introduction: The aim of the study was to identify clinical indications for head computed tomography (HCT) in children with mild head injuries (MHI).

Materials and methods: A retrospective analysis of medical documentation for 1615 children treated between 2010–2015 due to head injuries was carried out. Only patients with MHI and HCT were included in the study. Mild head injuries was defined as blunt trauma of the head with minimally altered mental status measured by the Glasgow Coma Scale (GCS, 14/15) and/or loss of consciousness (LOC) less than 5 min and no focal neurologic deficit (Scandinavian Neurotrauma Committee). Mental status was assessed with GCS for adults/children depending on the patient’s age. The demographic characteristics of the children including age, sex, mechanism of the trauma, findings on history, physical examinations, and HCT scans were documented. Statistical analysis was preformed to find the relationship between clinical signs and abnormal HCT scan.

Results: The mean age was 9 years and 10 months, and 98 (60%) of the children were male. The vast majority of the children (149.92%) had a GCS score of 15. The most common mechanism of injury was a fall from a height (25%) and vehicle crash (22%). The most common indications for HCT scan were headache (50%) and LOC (39%). The incidence of positive HCT findings was 31%. Only 7 (4%) children required neurosurgical intervention. There was a significant correlation between abnormal HCT in the vehicle crash mechanism of injury, vomiting, and clinical signs of basilar/maxillofacial skull fracture.

Conclusions: Head computed tomography is indicated in children with MHI caused by vehicle crash, presence of vomiting, and clinical signs of basilar/maxillofacial fracture.


child; mild head injury; head computer tomography

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