The Relationship between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head Trauma Admitted to Hospital

Abstract

In Emergency Medicine for determining the intracranial injury (ICI) in children with head trauma, usually Brain CT Scan is performed. Since Brain CT Scan especially in children has some disadvantages, it is ideal to find a method which could help to choose only the children with real head trauma injury for Brain CT Scan. This study was descriptive, Analytic and Non interventional. We reviewed the archived files of children with head trauma injuries admitted in emergency department of Imam Hossein hospital within two years. Patient’s CT scan findings and head trauma risk factors were evaluated in this study. Out of 368 patients, 326 patients had normal Brain CT Scan. 28 of them showed signs of ICI consisting intraventrucular hemorrhage (IVH), Contusion, subarachnoid hemorrhage (SAH), subdural hemorrhage (SDH), epidural hematoma (EDH), and Pneumocephalus. Twenty-seven patients showed Skull FX, which14 of them had Isolated Fracture, and 13 of them showed also signs of ICI. Since, patients with isolated FX usually discharge quickly from Emergency Department; their data did not include in outcome of this study. The Patients has been divided into two groups: 1- ICI, 2- without ICI. RR (relative risk), CI (Confidence interval) and sensitivity, positive predictive value (PPV), negative predictive value (NPV) and association of these risk factors with ICI were assessed with Chi-2 test. In the end to determine the indications of CT scan, presence of one of these five risk factors is important including: Abnormal Mental Status, Clinical signs of Skull FX, history of vomiting, Craniofacial Soft Tissue Injury (including Subgaleal Hematomas or Laceration) and Headache. For all other patients without these risk factors, observation and Follow Up can be used which has more advantages and less cost.