S M Ng1, E M Toh, C A Sherrington. 1. Department of Paediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia. ngszemay@yahoo.com
Abstract
OBJECTIVE: To evaluate whether clinical features associated with head injury in children can be correlated with an abnormal computed tomography (CT) scan. METHODOLOGY: Three hundred and eleven children aged 14 years or younger admitted with a diagnosis of acute head injury were studied retrospectively. RESULTS: 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. CONCLUSION: 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.
OBJECTIVE: To evaluate whether clinical features associated with head injury in children can be correlated with an abnormal computed tomography (CT) scan. METHODOLOGY: Three hundred and eleven children aged 14 years or younger admitted with a diagnosis of acute head injury were studied retrospectively. RESULTS: 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. CONCLUSION: 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.