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Int J Med Invest 2021, 10(4): 102-107 Back to browse issues page
Descriptive Study Of Physical And Imaging Examination Finings Of Head Trauma In Children Under 2 Years Of Old
Robab Sadegh * , Zeinab Salehi, Razieh Sadat Mousavi Rokn Abadi, Mehrdad Sharifi
Assistant Professor of Emergency Medicine - Emergency Medicine Specialist, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract:   (104 Views)
Background: One of the most common pediatric reasons for Emergency Department (ED) referral in childhood is head trauma. Computed tomography (CT) is the standard diagnostic test in the definition of pathologies after head trauma. However, the results of studies related to ionization-induced cancer and the need for sedation during scanning in pediatric have raised concerns about the application of CT, especially in young patients. The present study aims to investigate the compliance of pediatric brain CT scan requests with clinical examinations.
Methods: We evaluated minor head trauma children aged below two years old in Namazi hospital, Shiraz, Iran. In this retrospective cross-sectional study, 234 children were evaluated with mild Traumatic brain injury (TBI) from March 2017 to February 2019 brought to the emergency department. 234 patients with a mean age of 12.06±6.84 months were evaluated. Physical examination revealed that a Palpable skull fracture happened in 1 (0.4%), a Parietal scalp hematoma in 16 (6.8%), Occipital scalp hematoma in 11 (4.7%), and temporal scalp hematoma in 7 (3%) patients. Most findings on CT scans were Linear Skull Fracture in 75(32.05%) cases. 90(38.46%) patients had normal CT scans. In patients with positive clinical examination findings, 23.2% of the patients had a positive CT finding; while only 7.3% of the patients with no clinical symptoms had a positive CT finding, indicating a significant difference (P=0.002). A significantly lower age was seen in patients with positive CT scan findings (Mann–Whitney test, P=0.049).
Conclusion: To conclude, our study shows that in most cases, a brain CT scan seems to be unnecessary; while physicians should consider all clinical aspects to decide a CT scan request.
Keywords: CT scan, emergency medicine, pediatric, traumatic brain injury.
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Type of Study: Research | Subject: General
References
1. 1. Ballesteros MF, Williams DD, Mack KA, Simon TR, Sleet DA. The epidemiology of unintentional and violence-related injury morbidity and mortality among children and adolescents in the United States. International journal of environmental research and public health. 2018; 15 (4): 616. 2. Centers for Disease Control and Prevention: Web-Based Injury Statistics Query and Reporting System [WISQARS] 2016 [Available from: https://www.cdc.gov/injury/wisqars/index.html. 3. Menon DK, Schwab K, Wright DW, Maas AI. Position statement: definition of traumatic brain injury. Archives of physical medicine and rehabilitation. 2010; 91 (11): 1637- 40.. 4. Jalalvandi F, Arasteh P, Safari Faramani R, Esmaeilivand M. Epidemiology of Pediatric Trauma and Its Patterns in Western Iran: A Hospital Based Experience. Glob J Health Sci. 2015; 8 (6): 139-46. 5. Tintinalli JE, Cline DM, Ma OJ, Cydulka RK, Meckler G. Tintinalli's Emergency Medicine Manual 9th Edition: McGraw Hill Professional; 2020. 6. Chang M, Stewart R, Rotondo M, Nathens A. National Trauma Data Bank 2016 Pediatric Annual Report. : 2016. . 7. Rangel-Castilla L, Lara LR, Gopinath S, Swank PR, Valadka A, Robertson C. Cerebral hemodynamic effects of acute hyperoxia and hyperventilation after severe traumatic brain injury. Journal of neurotrauma. 2010; 27 (10): 1853-63. . 8. Robertson CS. Management of cerebral perfusion pressure after traumatic brain injury. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2001; 95 (6): 1513-7. . 9. American Academy of Pediatrics (1999) The management of minor closed head injury in children. Pediatrics 104:1407–15 10. Joyner Jr BL. Does Family Presence in the Trauma Bay Help or Hinder Care? AMA journal of ethics. 2018; 20 (5): 507-12. 11. Vink R, Head VA, Rogers PJ, McINTOSH TK, Faden AI. Mitochondrial metabolism following traumatic brain injury in rats. Journal of neurotrauma. 1990; 7 (1): 21-7. . 12. Lifshitz J, Sullivan PG, Hovda DA, Wieloch T, McIntosh TK. Mitochondrial damage and dysfunction in traumatic brain injury. Mitochondrion. 2004; 4 (5-6): 705-13. 13. Centers for Disease Control and Prevention: Vital Statistics 2008 [Available from: http://www.cdc.gov/nchs/vitalstats.htm . 14. Palchak MJ, Holmes JF, Vance CW et al (2003) A decision rule for identifying children at low risk for brain injuries after blunt head trauma. Ann Emerg Med 42:492–506 15. Güzel A, Hiçdönmez T, Temizöz O, Aksu B, Aylanç H, Karasalihoglu S (2009) Indications for brain computed tomography and hospital admission pediatric patients with minor head injury: how much can we rely upon clinical findings? Pediatr Neurosurg 45:262–70 16. RAGHUPATHI R, GRAHAM DI, McINTOSH TK. Apoptosis after traumatic brain injury. Journal of neurotrauma. 38- 927:) 10 (17; 2000.. 17. SMITH DH, CHEN XH, PIERCE JE, WOLF JA, TROJANOWSKI JQ, GRAHAM DI, et al. Progressive atrophy and neuron death for one year following brain trauma in the rat. Journal of neurotrauma. 1997; 14 (10): 715-27. . 18. Papadopoulos MC, Krishna S, Verkman A. Aquaporin water channels and brain edema. The Mount Sinai journal of medicine, New York. 2002; 69 (4): 242-8. . 19. Papadopoulos MC, Verkman AS. Aquaporin-4 and brain edema. Pediatric nephrology. 2007; 22 (6): 778-84. . 20. Engbrecht BW, Baertschiger RM. American pediatric surgical association trauma committee position statement on the use of all-terrain vehicles by children and youth, 2018. Journal of pediatric surgery. 2018; 53 (7): 1444-5. .
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Sadegh R, Salehi Z, Abadi R S M R, Sharifi M. Descriptive Study Of Physical And Imaging Examination Finings Of Head Trauma In Children Under 2 Years Of Old. Int J Med Invest. 2021; 10 (4) :102-107
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Volume 10, Issue 4 (12-2021) Back to browse issues page
International Journal of Medical Investigation
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