Poor prediction of positive computed tomographic scans by clinical criteria in symptomatic pediatric head trauma.

A retrospective study of 98 children who received CT scanning for head trauma was conducted to determine whether clinical signs would accurately identify patients needing CT scans. The clinical findings of Glasgow Coma Scale score of 12 or less, altered consciousness on admission, and focal abnormalities on neurologic examination were each significantly associated with abnormal findings on CT scans (P less than .01). However, 31% of the 51 patients with Glasgow Coma Scale scores greater than 12 had abnormal CT scan findings. No clinical findings, alone or in combination, accurately identified all patients with abnormal findings on CT scans.