Ng S M, Toh E M, Sherrington C A
Department of Paediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia.
J Paediatr Child Health. 2002 Aug;38(4):388-92. doi: 10.1046/j.1440-1754.2002.00012.x.
To evaluate whether clinical features associated with head injury in children can be correlated with an abnormal computed tomography (CT) scan.
Three hundred and eleven children aged 14 years or younger admitted with a diagnosis of acute head injury were studied retrospectively.
A Glasgow Coma Scale (GCS) score of 12 or lower and the presence of focal neurological deficits were significant predictors of an abnormal CT scan. Ninety-five per cent of those with abnormal CT scans and 100% of those with intracranial injury could be identified by the presence of one or more of the nine clinical findings, particularly by a GCS score of 12 or lower, and the presence of focal neurological deficits. Identification was also possible to a lesser degree by loss of consciousness, ataxia, amnesia, drowsiness, headache, seizure or vomiting.
Use of CT scans can be limited to children with ongoing specific symptoms and/or focal neurological signs. The implementation of guidelines in the management of head injuries in children could have a substantial effect on clinical practice and health-care costs.
评估儿童头部损伤的临床特征是否与计算机断层扫描（CT）异常相关。
回顾性研究311名14岁及以下诊断为急性头部损伤的儿童。
格拉斯哥昏迷量表（GCS）评分为12分及以下以及存在局灶性神经功能缺损是CT扫描异常的重要预测指标。通过九项临床发现中的一项或多项，特别是GCS评分为12分及以下和存在局灶性神经功能缺损，可识别出95%的CT扫描异常儿童和100%的颅内损伤儿童。意识丧失、共济失调、失忆、嗜睡、头痛、癫痫发作或呕吐在较小程度上也可用于识别。
CT扫描的使用可限于有持续特定症状和/或局灶性神经体征的儿童。实施儿童头部损伤管理指南可能会对临床实践和医疗保健成本产生重大影响。
