What is the Diagnostic Value of Computed Tomography in Pre-school Children with Minor Head Injuries?

Objective: In this study, we evaluated whether computed tomography (CT) examination would be required or not, based on complaints and findings after minor head trauma in pre-school children.
Methods: In our retrospective study, the history of pre-school patients with minor head trauma, physical examination findings, Glasgow coma scale, cranial radiography, CT findings, and injury were evaluated retrospectively. The duration of unconsciousness and amnesia, presence of post-traumatic seizure, history of vomiting, and presence of scalp injury/hematoma were examined in the patient’s records. Clinical and radiological information was obtained retrospectively, and patients were re-evaluated one year later by phone. The fractures, edema, contusion, pneumocephalus, epidural hematoma, subdural hematoma, intraparenchymal hematoma, and intraventricular hemorrhage were evaluated on CT examination.
Results: Between May 2014 and May 2018, 884 patients under 7 years of age with minor head injuries were evaluated in the emergency department. Among these, anterior-posterior and lateral cranial radiography and CT were performed in 262 patients. None of the patients had neurological deficits. Scalp laceration/hematoma was detected in 36 (16%) patients. Fifty-two (24%) patients vomited once, whereas 12 (5%) and 5 (2%) vomited twice and thrice, respectively. A loss of consciousness (LOC) duration of <5 min was observed in 25 (11%) patients. None of the patients had a history of LOC duration of more than 5 min. However, all three patients with skull fracture had a history of LOC.
Conclusion: We believe that clinical examination and other imaging methods may reduce the need for CT evaluation in pre-school childhood patients with minor head trauma.