Minor head injury in children

被引:3
作者
Klig, Jean E. [2 ]
Kaplan, Carl P. [1 ]
机构
[1] SUNY Stony Brook, Sch Med, Stony Brook Univ Hosp, Pediat Emergency Dept, Stony Brook, NY 11794 USA
[2] Harvard Univ, Sch Med, Massachusetts Gen Hosp Children, Pediat Emergency Dept, Boston, MA 02115 USA
关键词
mild traumatic brain injury; minor head injury; pediatrics; DECISION RULE; PREDICTION; CANCER; RISKS; CT;
D O I
10.1097/MOP.0b013e328339736e
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose of review This review will examine mild closed head injury (CHI) and the current evidence on head computed tomography (CT) imaging risks in children, prediction rules to guide decisions on CT scan use, and issues of concussion after initial evaluation. Recent findings The current literature offers preliminary evidence on the risks of radiation exposure from CT scans in children. A recent study introduces a validated prediction rule for use in mild CHI, to limit the number of CT scans performed. Concurrent with this progress, fast (or short sequence) MRI represents an emerging technology that may prove to be a viable alternative to CT scan use in certain cases of mild CHI where imaging is desired. The initial emergency department evaluation for mild CHI is the start point for a sequence of follow-up to assure that postconcussive symptoms fully resolve. The literature on sports-related concussion offers some information that may be used for patients with non-sports-related concussion. Summary It is clear that CT scan use should be as safe and limited in scope as possible for children. Common decisions on the use of CT imaging for mild head injury can now be guided by a prediction rule for clinically important traumatic brain injury. Parameters for the follow-up care of patients with mild CHI after emergency department discharge are needed in the future to assure that postconcussive symptoms are adequately screened for full resolution.
引用
收藏
页码:257 / 261
页数:5
相关论文
共 17 条
[1]   Understanding predictors of functional recovery and outcome 30 months following early childhood head injury [J].
Anderson, VA ;
Catroppa, C ;
Dudgeon, P ;
Morse, SA ;
Haritou, F ;
Rosenfeld, JV .
NEUROPSYCHOLOGY, 2006, 20 (01) :42-57
[2]   A clinical decision rule for cranial computed tomography in minor pediatric head trauma [J].
Atabaki, Shireen M. ;
Stiell, Ian G. ;
Bazarian, Jeffrey J. ;
Sadow, Karin E. ;
Vu, Tien T. ;
Camarca, Mary A. ;
Berns, Scott ;
Chamberlain, James M. .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2008, 162 (05) :439-445
[3]   Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative [J].
Brenner, DJ .
PEDIATRIC RADIOLOGY, 2002, 32 (04) :228-231
[4]   Estimated risks of radiation-induced fatal cancer from pediatric CT [J].
Brenner, DJ ;
Elliston, CD ;
Hall, EJ ;
Berdon, WE .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 176 (02) :289-296
[5]   Sports-related concussions in pediatrics [J].
Cohen, Joanna S. ;
Gioia, Gerard ;
Atabaki, Shireen ;
Teach, Stephen J. .
CURRENT OPINION IN PEDIATRICS, 2009, 21 (03) :288-293
[6]   Derivation of the children's head injury algorithm for the prediction of important clinical events decision rule for head injury in children [J].
Dunning, J. ;
Daly, J. Patrick ;
Lomas, J-P ;
Lecky, F. ;
Batchelor, J. ;
Mackway-Jones, K. .
ARCHIVES OF DISEASE IN CHILDHOOD, 2006, 91 (11) :885-891
[7]   The Image Gently campaign:: Working together to change practice [J].
Goske, Marilyn J. ;
Applegate, Kimberly E. ;
Boylan, Jennifer ;
Butler, Priscilla F. ;
Callahan, Michael J. ;
Coley, Brian D. ;
Farley, Shawn ;
Frush, Donald P. ;
Hernanz-Schulman, Marta ;
Jaramillo, Diego ;
Johnson, Neil D. ;
Kaste, Sue C. ;
Morrison, Greg ;
Strauss, Keith J. ;
Tuggle, Nora .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2008, 190 (02) :273-274
[8]   Radiation exposure from pediatric head CT: a bi-institutional study [J].
King, Mary A. ;
Kanal, Kalpana M. ;
Relyea-Chew, Annemarie ;
Bittles, Mark ;
Vavilala, Monica S. ;
Hollingworth, William .
PEDIATRIC RADIOLOGY, 2009, 39 (10) :1059-1065
[9]   Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study [J].
Kuppermann, Nathan ;
Holmes, James F. ;
Dayan, Peter S. ;
Hoyle, John D., Jr. ;
Atabaki, Shireen M. ;
Holubkov, Richard ;
Nadel, Frances M. ;
Monroe, David ;
Stanley, Rachel M. ;
Borgialli, Dominic A. ;
Badawy, Mohamed K. ;
Schunk, Jeff E. ;
Quayle, Kimberly S. ;
Mahajan, Prashant ;
Lichenstein, Richard ;
Lillis, Kathleen A. ;
Tunik, Michael G. ;
Jacobs, Elizabeth S. ;
Callahan, James M. ;
Gorelick, Marc H. ;
Glass, Todd F. ;
Lee, Lois K. ;
Bachman, Michael C. ;
Cooper, Arthur ;
Powell, Elizabeth C. ;
Gerardi, Michael J. ;
Melville, Kraig A. ;
Muizelaar, J. Paul ;
Wisner, David H. ;
Zuspan, Sally Jo ;
Dean, J. Michael ;
Wootton-Gorges, Sandra L. .
LANCET, 2009, 374 (9696) :1160-1170
[10]   Pediatric head trauma: the evidence regarding indications for emergent neuroimaging [J].
Kuppermann, Nathan .
PEDIATRIC RADIOLOGY, 2008, 38 (Suppl 4) :S670-S674