CT scan

Study finds CT scans are frequently unnecessary after head injury in children

Overall, roughly half of U.S. children taken to hospital emergency departments (EDs) for a head injury receive a head CT scan, often to ease worried parents’ concerns. Yet true traumatic brain injury is uncommon. A multi-center study of more than 40,000 children with minor blunt head trauma, led by Children’s and UC Davis, shows that allowing a period of observation can reduce the use of head CT by as much as half without compromising care--and without exposing children to ionizing radiation.
 
“Only a small percentage of children with blunt head trauma really have something serious going on,” says Children’s Lise Nigrovic, MD, MPH, who co-led the study “If you can be watched in the ED for a few hours, you may not need a CT.”
 
Nigrovic and colleagues analyzed the outcomes of children presenting at 25 different emergency departments. Of 40,113 children whose records could be analyzed, 5,433 were observed before making a decision about CT use. Overall, the children who were observed had a lower rate of CT than those not observed. In particular, children whose symptoms improved during observation were less likely to eventually have CT, and allowing for an observation period did not compromise safety, the study found.
 
This change in practice would not only be cost-saving, but is better medicine, the researchers say.
 
(Pediatrics, June 2011)