Zia Ziabari Seyyed Mahdi, Asadi Payman, Reihanian Zoheir, Rafieezadeh Aryan, Noori Roodsari Nazanin, Tavakoli Ilnaz, Eslami-Kenarsari Habib, Seifi Golnoosh
Department of Emergency Medicine, School of Medicine, Guilan University of Medical Sciences Rasht, Iran.
Guilan Road Trauma Research Center, Guilan University of Medical Sciences Rasht, Iran.
Int J Burns Trauma. 2022 Dec 15;12(6):261-268. eCollection 2022.
The most common cause of death or severe impairment in children older than one-year-old is traumatic brain injury (TBI). Assessing TBI in children with minor head trauma (MHT) using clinical findings from history-taking and a physical exam is crucial to minimizing unnecessary brain CTs and more accurately predicting TBI. We aimed to evaluate the findings of brain CT scans in children with mild head trauma and their relationship with clinical signs and symptoms to avoid unnecessary interventions in many children with MHT.
This cross-sectional-analytical study was performed to evaluate the findings of brain CT scans in children with MHT and their relationship with clinical signs and symptoms that were referred to Poursina Hospital in Rasht in the first half of 2021. Children were divided into two age groups: under two years and 2-12 years, and analyzed separately. Initially, a list containing all demographic information, patients' clinical signs, and symptoms were prepared. The collected data were then analyzed using SPSS software version 26.
According to the results, the mean age of patients was 66.01 months and 88 were boys (56.4%). The most common mechanism of injury was falling from a height. Most patients had isolated head injuries. Among the accompanying injuries, facial injuries were the most common. Among the clinical factors studied, cranial fracture on CT scan and GCS less than 15 were significantly associated with the occurrence of traumatic brain injury on CT scan. In addition, cranial fracture on CT scan, injury severity, and history of vomiting had the highest positive predictive value, respectively.
Standard history and clinical examination are sufficient to identify high-risk cases of pediatric head injuries. GCS is the most important risk factor for pediatric MHT. Requesting a CT scan is not recommended without these risk factors.
一岁以上儿童死亡或严重损伤的最常见原因是创伤性脑损伤（TBI）。利用病史采集和体格检查的临床结果来评估轻度头部创伤（MHT）儿童的TBI，对于减少不必要的脑部CT检查以及更准确地预测TBI至关重要。我们旨在评估轻度头部创伤儿童的脑部CT扫描结果及其与临床体征和症状的关系，以避免对许多MHT儿童进行不必要的干预。
本横断面分析研究旨在评估2021年上半年转诊至拉什特布尔西纳医院的MHT儿童的脑部CT扫描结果及其与临床体征和症状的关系。儿童被分为两个年龄组：两岁以下和2至12岁，并分别进行分析。最初，准备了一份包含所有人口统计学信息、患者临床体征和症状的清单。然后使用SPSS 26版软件对收集的数据进行分析。
根据结果，患者的平均年龄为66.01个月，88名是男孩（56.4%）。最常见的受伤机制是从高处坠落。大多数患者有孤立的头部损伤。在伴随损伤中，面部损伤最为常见。在所研究的临床因素中，CT扫描显示颅骨骨折和格拉斯哥昏迷量表（GCS）评分低于15与CT扫描显示的创伤性脑损伤显著相关。此外，CT扫描显示颅骨骨折、损伤严重程度和呕吐史的阳性预测价值最高。
标准的病史和临床检查足以识别小儿头部损伤的高危病例。GCS是小儿MHT最重要的危险因素。没有这些危险因素不建议进行CT扫描。
