scholarly journals Predicting factors for abnormal brain computed tomography in children with minor head trauma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Taraneh Naghibi ◽  
Mina Rostami ◽  
Behrad Jamali ◽  
Zhaleh Karimimoghaddam ◽  
Alireza Zeraatchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head Trauma ◽  
Clinical Findings ◽  
Cranial Computed Tomography ◽  
Minor Head Trauma ◽  
Brain Ct ◽  
Predicting Factors ◽  
Level Of Consciousness ◽  
The Impact ◽  
Abnormal Brain

Abstract Background Deciding whether a cranial Computed Tomography (CT) scan in a patient with minor head trauma (MHT) is necessary or not has always been challenging. Diagnosing Traumatic Brain Injury (TBI) is a fundamental part of MHT managing especially in children who are more vulnerable in terms of brain CT radiation consequences and TBI. Defining some indications to timely and efficiently predict the likelihood of TBI is necessary. Thus, we aimed to determine the impact of clinical findings to predict the need for brain CT in children with MHT. Methods In a prospective cohort study, 200 children (2 to 14 years) with MHT were included from 2019 to 2020. The data of MHT-related clinical findings were gathered. The primary and secondary outcomes were defined as a positive brain CT and any TBI requiring neurosurgery intervention, respectively. In statistical analysis, we performed Binary Logistic regression analysis, Fisher’s exact test and independent samples t-test using SPSS V.26. Results The mean age of participants was 6.5 ± 3.06 years. Ninety patients underwent brain CT. The most common clinical finding and injury mechanism were headache and falling from height, respectively. The results of brain CTs were positive in seven patients (3.5%). We identified three predicting factors for an abnormal brain CT including headache, decreased level of consciousness, and vomiting. Conclusion We showed that repetitive vomiting (≥2), headache, and decreased level of consciousness are predicting factors for an abnormal brain CT in children with MHT.

Pediatric Minor Head Trauma: Factors Affecting the Anxiety of Parents

2021 ◽  
pp. 000992282110096
Author(s):  
Hasan Aldinc ◽  
Cem Gun ◽  
Serpil Yaylaci ◽  
Erol Barbur
Keyword(s):  
Computed Tomography ◽  
Head Trauma ◽  
Pediatric Patients ◽  
Positive Impact ◽  
Cranial Computed Tomography ◽  
Sufficient Information ◽  
Minor Head Trauma ◽  
Computed Tomography Imaging ◽  
Factors Affecting ◽  
X Ray

Managing the anxiety of the parents of pediatric patients with head trauma is challenging. This study aimed to examine the factors that affect anxiety levels of parents whose children were admitted to the emergency department with minor head trauma. In this prospective study, the parents of 663 consecutive pediatric patients were invited to answer a questionnaire. Parents of 600 children participated in the study. The parents who believed they were provided sufficient information and who were satisfied with the service received had significantly more improvement in anxiety-related questions. Cranial X-ray assessment had a significantly positive impact on the anxiety of the parents, whereas cranial computed tomography and neurosurgery consultation did not. In assessing pediatric minor head trauma, cranial computed tomography imaging and neurosurgery consultation should not be expected to relieve the anxiety of the parents. However, adequately informing them and providing satisfaction are the factors that could lead to improvement.

scholarly journals The Effect of Patient Observation on Cranial Computed Tomography Rates in Children With Minor Head Trauma

2020 ◽  
Vol 27 (9) ◽  
pp. 832-843 ◽  
Author(s):  
Sonia Singh ◽  
Stephen J. C. Hearps ◽  
Meredith L. Borland ◽  
Stuart R. Dalziel ◽  
Jocelyn Neutze ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head Trauma ◽  
Cranial Computed Tomography ◽  
Minor Head Trauma

Prospective Study of Validity of Neurologic Signs in Predicting Positive Cranial Computed Tomography following Minor Head Trauma

2010 ◽  
Vol 25 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Yassir S. Abdul Rahman ◽  
Ahmed Sami S. Al Den ◽  
Kimball I. Maull
Keyword(s):  
Computed Tomography ◽  
Head Injury ◽  
Prospective Study ◽  
Head Trauma ◽  
Clinical Findings ◽  
Cranial Computed Tomography ◽  
Loss Of Consciousness ◽  
Mild Head Injury ◽  
Cranial Ct ◽  
Ct Findings

AbstractIntroduction:The ability to discriminate among a large number of patients with mild head injury to detect those most likely to have an intracranial abnormality may offer an advantage in mass-casualty situations and when clinical needs exceed diagnostic capabilities.Hypothesis:In patients with mild head injury (Glasgow Coma Scale score = 13−15), the likelihood of intracranial abnormality, as defined by cranial computed tomography (CT), varies according to presenting neurologic signs and symptoms.Methods:This prospective study consisted of 152 patients with blunt head trauma and one or more of the following: initial loss of consciousness (LOC), headache, vomiting, convulsions, or amnesia. All underwent cranial CT within one hour of presentation. Positive CT findings were defined as cerebral contusion, extra-axial hematoma, intra-ventricular or subarachnoid hemorrhage, brain edema, and skull fracture. Clinical findings were tabulated and compared with CT findings.Results:The most common symptoms were headache (61%) followed by followed by LOC (45%), vomiting (39%), amnesia (29%), and convulsions (4%). Convulsions were the most predictive of a CT positive finding (80%); history of LOC was least predictive (29%). The presence of two or more clinical findings tended to increase the likelihood of intracranial abnormality, but the association was neither consistent nor additive.Conclusions:Convulsions occurring in a patient with mild head injury are highly predictive of a positive intracranial finding on CT. Headache, amnesia, and vomiting are each likely to show positive findings in approximately 40–45% of cases. Although the least predictive of the neurologic findings studied, loss of consciousness still correlates with a positive cranial CT in 29% of cases. More than one sign or symptom increases the likelihood of concurrent brain injury.

Serum S100β Neuroprotein Reduces Use of Cranial Computed Tomography in Children After Minor Head Trauma

Shock ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 410-416 ◽  
Author(s):  
Jeanne Simon-Pimmel ◽  
Fleur Lorton ◽  
Nicolas Guiziou ◽  
Karine Levieux ◽  
Bénédicte Vrignaud ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head Trauma ◽  
Cranial Computed Tomography ◽  
Minor Head Trauma

scholarly journals Development, Evaluation and Implementation of Chief Complaint Groupings to Activate Data Collection

2015 ◽  
Vol 06 (03) ◽  
pp. 521-535 ◽  
Author(s):  
L. Bajaj ◽  
J. Hoffman ◽  
E. Alessandrini ◽  
D. W. Ballard ◽  
R. Norris ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Trial ◽  
Data Collection ◽  
Head Trauma ◽  
High Sensitivity ◽  
Clinical Decision ◽  
Chief Complaint ◽  
Cranial Computed Tomography ◽  
Blunt Head Trauma ◽  
Development Evaluation

SummaryBackground: Overuse of cranial computed tomography scans in children with blunt head trauma unnecessarily exposes them to radiation. The Pediatric Emergency Care Applied Research Network (PECARN) blunt head trauma prediction rules identify children who do not require a computed tomography scan. Electronic health record (EHR) based clinical decision support (CDS) may effectively implement these rules but must only be provided for appropriate patients in order to minimize excessive alerts.Objective: To develop, implement and evaluate site-specific groupings of chief complaints (CC) that accurately identify children with head trauma, in order to activate data collection in an EHR.Methods: As part of a 13 site clinical trial comparing cranial computed tomography use before and after implementation of CDS, four PECARN sites centrally developed and locally implemented CC groupings to trigger a clinical trial alert (CTA) to facilitate the completion of an emergency department head trauma data collection template. We tested and chose CC groupings to attain high sensitivity while maintaining at least moderate specificity.Results: Due to variability in CCs available, identical groupings across sites were not possible. We noted substantial variability in the sensitivity and specificity of seemingly similar CC groupings between sites. The implemented CC groupings had sensitivities greater than 90% with specificities between 75–89%. During the trial, formal testing and provider feedback led to tailoring of the CC groupings at some sites.Conclusion: CC groupings can be successfully developed and implemented across multiple sites to accurately identify patients who should have a CTA triggered to facilitate EHR data collection. However, CC groupings will necessarily vary in order to attain high sensitivity and moderate-to-high specificity. In future trials, the balance between sensitivity and specificity should be considered based on the nature of the clinical condition, including prevalence and morbidity, in addition to the goals of the intervention being considered.Citation: Deakyne SJ, Bajaj L, Hoffmann J, Alessandrini E, Ballard DW, Norris R, Tzimenatos L, Swietlik M, Tham E, Grundmeier RW, Kuppermann N, Dayan PS. Development, Evaluation and Implementation of Chief Complaint Groupings to Activate Data Collection in a Multi-Center Study of Clinical Decision Support for Children with Head Trauma. Appl Clin Inform 2015; 6: 521–535http://dx.doi.org/10.4338/ACI-2015-02-RA-0019

Can a CT be Omitted in Pediatric Minor Head Trauma?

2017 ◽  
Vol 16 (01) ◽  
pp. 001-007
Author(s):  
Maria Sinzig ◽  
Eveline Achatz ◽  
Günter Fasching ◽  
Christoph Arneitz
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Head Trauma ◽  
Neurological Status ◽  
Ct Scans ◽  
Minor Head Trauma ◽  
Pediatric Ct ◽  
Ct Protocol ◽  
In Infants And Children

AbstractThis study aimed to evaluate the need for radiation exposure in pediatric minor head trauma. Symptomatic patients after minor head trauma were observed for at least 24 hours in a 13-month period. A computed tomography (CT) scan was performed on children with a depressed neurological status. Two hundred fourteen patients with a mean age of 9.3 years were included. An intracranial hemorrhage (ICH) was diagnosed in three (1.4%) patients. The overall CT rate was 10.7%. The study concluded that neuro-observation without initial CT scans is safe in infants and children following minor head trauma. Special pediatric CT protocol can limit radiation exposure.

Minor head trauma and linear skull fracture in infants: cranial ultrasound or computed tomography?

2009 ◽  
Vol 16 (3) ◽  
pp. 150-152 ◽  
Author(s):  
Victoria Trenchs ◽  
Ana I. Curcoy ◽  
Marta Castillo ◽  
Josep Badosa ◽  
Carles Luaces ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head Trauma ◽  
Skull Fracture ◽  
Cranial Ultrasound ◽  
Minor Head Trauma

scholarly journals Timing of presentation and correlation with computed tomography in pediatric patients with minor head trauma

2018 ◽  
Vol 5 (6) ◽  
pp. 2038
Author(s):  
Karthick Jayapal ◽  
Hassan Adnan Mansour
Keyword(s):  
Computed Tomography ◽  
Head Trauma ◽  
Cross Sectional Study ◽  
Minor Head Trauma ◽  
Cross Sectional ◽  
Increased Risk ◽  
Key Factor ◽  
History Of ◽  
Study Participants ◽  
Type Of Injury

Background: The presentation of minor head trauma warrants immediate and accurate diagnosis for early clinical management among children. Computed Tomography is the gold standard tool for the diagnosis of Traumatic Brain Injury (TBI) among the children. The timing of presentation may have a significant role in predicting the incidence of TBI. This study was done to compare the CT findings among children who presented within and after 24 hours with minor head trauma.Methods: This cross-sectional study was carried out among 992 children between 2-15 years reporting with a history of head injury. All the participants were clinically examined, and relevant history of type of injury and timing of presentation was recorded. CT scan was taken as per PECARN criteria. Data was entered and analysed using SPSS ver 15 software.Results: Majority of the participants belonged to 6-10 years of age (45.2%) and were males (58.5%). About 81.7% of the participants presented within 24 hours. The overall prevalence of TBI among the study participants was 58.6% [55.5-61.6].It was observed that hematoma predominantly presented after 24 hours (74.2%) and majority of the falls presented after 24 hours (92.8%).Patients who presented after 24 hours were at increased risk of presenting as TBI (67.03%) compared to those presenting within 24 hours (56.8%;p<0.05).Conclusions: This study has emphasized the need for including the timing of presentation as a key factor for facilitating early diagnosis and rapid case management of pediatric head trauma.

scholarly journals Hyperglycemia in pediatric head trauma patients: a cross-sectional study

2009 ◽  
Vol 67 (3b) ◽  
pp. 804-806 ◽  
Author(s):  
José Roberto Tude Melo ◽  
Rodolfo Casimiro Reis ◽  
Laudenor Pereira Lemos-Júnior ◽  
Henrique Miguel Santos Coelho ◽  
Carlos Eduardo Romeu de Almeida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head Trauma ◽  
Cross Sectional Study ◽  
Cranial Computed Tomography ◽  
Trauma Patients ◽  
Severe Head Trauma ◽  
Sectional Study ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Computed Tomography Scans

OBJECTIVE: To verify the prevalence of acute hyperglycemia in children with head trauma stratified by the Glasgow coma scale (GCS). METHOD: A prospective cross-sectional study carried out with information from medical records of pediatric patients presenting with head injury in the emergency room of a referral emergency hospital during a one year period. We considered the cut-off value of 150 mg/dL to define hyperglycemia. RESULTS: A total of 340 children were included and 60 (17.6%) had admission hyperglycemia. Hyperglycemia was present in 9% of mild head trauma cases; 30.4% of those with moderate head trauma and 49% of severe head trauma. We observed that among children with higher blood glucose levels, 85% had abnormal findings on cranial computed tomography scans. CONCLUSION: Hyperglycemia was more prevalent in patients with severe head trauma (GCS <8), regardless if they had or not multiple traumas and in children with abnormal findings on head computed tomography scans.

Sign in / Sign up

Export Citation Format

Share Document