Predicting factors for abnormal brain computed tomography in children with minor head trauma

BMC Emergency Medicine

Taraneh Naghibi¹  Asghar Jafari Rouhi²  Behrad Jamali²  Alireza Zeraatchi²  Zhaleh Karimimoghaddam³  Mina Rostami⁴ 

[1] Department of Anesthesiology and Critical Care Medicine, School of Medicine, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran;Department of Emergency Medicine, School of Medicine, Valiasr-e-Asr Hospital, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran;Department of Radiation Oncology, School of Medicine, Valiasr-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran;Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran;

关键词: Minor head trauma;    Children;    Traumatic brain injury;    Brain computed tomography scan;   

DOI  :  10.1186/s12873-021-00540-1

来源: Springer

【 摘 要 】

BackgroundDeciding whether a cranial Computed Tomography (CT) scan in a patient with minor head trauma (MHT) is necessary or not has always been challenging. Diagnosing Traumatic Brain Injury (TBI) is a fundamental part of MHT managing especially in children who are more vulnerable in terms of brain CT radiation consequences and TBI. Defining some indications to timely and efficiently predict the likelihood of TBI is necessary. Thus, we aimed to determine the impact of clinical findings to predict the need for brain CT in children with MHT.MethodsIn a prospective cohort study, 200 children (2 to 14 years) with MHT were included from 2019 to 2020. The data of MHT-related clinical findings were gathered. The primary and secondary outcomes were defined as a positive brain CT and any TBI requiring neurosurgery intervention, respectively. In statistical analysis, we performed Binary Logistic regression analysis, Fisher’s exact test and independent samples t-test using SPSS V.26.ResultsThe mean age of participants was 6.5 ± 3.06 years. Ninety patients underwent brain CT. The most common clinical finding and injury mechanism were headache and falling from height, respectively. The results of brain CTs were positive in seven patients (3.5%). We identified three predicting factors for an abnormal brain CT including headache, decreased level of consciousness, and vomiting.ConclusionWe showed that repetitive vomiting (≥2), headache, and decreased level of consciousness are predicting factors for an abnormal brain CT in children with MHT.

【 授权许可】

CC BY