Routine Repeat Head CT for Children with Traumatic Brain Injury Is Unwarranted

For children with mild-to-moderate brain injuries, clinical evaluation should direct need for repeat imaging.

To evaluate efficacy of repeat head computed tomography (CT) in pediatric patients with traumatic brain injuries (TBIs), investigators retrospectively evaluated records of 291 patients (age range, 2–18 years) with blunt TBIs and a positive initial head CT. A positive finding was defined as intracranial hemorrhage (ICH) or skull fracture. Based on presenting Glasgow Coma Scale (GCS), patients were categorized as mild (GCS score, 13–15), moderate (GCS score, 9–12), or severe TBI (GCS score, 3–8). Repeat head CT was either “routine” (ordered for the following 24–48 hours) or based on neurologic deterioration (decrease in GCS score or new neurologic symptoms).

GCS scores were mild for 218 patients, moderate for 15, and severe for 58. Among 191 (…

Reviewing Author

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Katherine Bakes, MD

Disclosures

RoyaltiesEmergency Medicine Secrets (Elsevier)

Grant/Research SupportDepartment of Justice

Editorial BoardsEmergency Medicine Secrets (Elsevier); Rosen’s Emergency Medicine (Elsevier)

Routine Repeat Head CT for Children with Traumatic Brain Injury Is Unwarranted

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Reviewing Author