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. |
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