Follow-Up Computed Tomography Requirement of Pediatric Head Trauma Patients with Abnormal Imaging Findings.

OBJECTIVE

We investigated pediatric patients presenting with isolated head trauma to emergency service. Where abnormal findings were detected on brain computed tomography (CT) scan, we evaluated the follow-up scan rate and whether follow-up scans affected the treatment protocol.

METHODS

Pediatric patients who presented to emergency service between 2014 and 2017 with isolated head trauma and were later found to have abnormal findings on CT scan were evaluated. The patients were evaluated in terms of age, sex, pediatric Glasgow Coma Scale score at emergency service, trauma mechanism, and abnormal findings on CT scan. We also documented whether follow-up CT scan altered the treatment decision in patients as to whether they underwent surgery or received conservative treatment.

RESULTS

The 105 head trauma patients with abnormal findings on CT scan consisted of 58 boys (55.2%) and 47 girls (44.8%). After the first brain CT examination, 5 of the patients (4.7%) underwent emergency surgery. For patients with linear fractures, the number of follow-up CT scans was 2.3. For patients with linear fractures, vomiting was found to be a symptom with statistical meaning as a sign of additional cranial pathology compared with headache, drowsiness, and irritability. A total of 280 follow-up CT scans with a mean number of 2.66 per patient were performed.

CONCLUSIONS

Follow-up CT scan for patients with abnormal findings on the initial CT scan after head trauma does not influence the decision to choose clinical observation or surgery except in patients with neurologic deterioration.