Computed Tomography Findings in Young Children with Minor Head Injury Presenting to the Emergency Department Greater than 24hrs Post Injury

Publication date: Available online 11 September 2017
Source:Injury
Author(s): Renana Gelernter, Giora Weiser, Eran Kozer
BackgroundLarge studies which developed decision rules for the use of Computed tomography (CT) in children with minor head trauma excluded children with late presentation (more than 24hours).Objective: To assess the prevalence of significant traumatic brain injury (TBI) on CT in infants with head trauma presenting to the emergency department (ED) more than 24hours from the injury.MethodsA retrospective chart review of infants less than 24 months old referred for head CT because of traumatic brain injury from January 2004 to December 2014 in Assaf-Harofeh medical center was conducted. We used the PECARN definitions of TBI on CT to define significant CT findings.Results344 cases were analyzed, 68 with late presentation.There was no significant difference in the age between children with late and early presentation (mean 11.4 (SD 5.6) month Vs 10. 5 (SD 7.0) month, P=0.27). There was no significant difference between the groups in the incidence of significant TBI (22% Vs 19%, p=0.61). Any TBI on CT (e.g. fracture) was found in 43 (63%) patients with late presentation compared with 116 (42%) patients with early presentation (p=0.002, OR 2.37, 95% CI 1.37 to 4.1).ConclusionA similar rate of CT-identified traumatic brain injury was detected in both groups.‏There was no significant difference in the incidence of significant TBI on CT between the groups.‏ Young children presenting to the ED more than 24 hours after the injury may have abnormal findings on CT.



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