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Most kids don’t require scans after head injury


Washington : Most kids who get CT (computed tomography) scans after seemingly minor head injuries do not need them. The scan only exposes them to heightened radiation risk and cancer, a new study says.

After analysing more than 42,000 children with head trauma, a team led by two University of California-Davis (UC-D) trauma physicians has developed guidelines to prevent children from exposure to such risks.

The study uses data collected at 25 hospitals from children who were evaluated for the possibility of serious brain injury following trauma to the head.

Researchers found that one in five children over the age of two and nearly a quarter of those under two, who received CT scans following head trauma, did not need them because they were at very low risk of having serious brain injuries.

In these low-risk children, the risk of developing cancer due to radiation exposure outweighed the risk of serious brain injury.

“When you have a sample size this large, it is easier to get your hands on the truth,” said Nathan Kuppermann, professor of emergency medicine and paediatrics at UC-D Children’s Hospital, who led the study.

“We think our investigation provides the best available evidence regarding the use of CT scans in children with head trauma, and it indicates that CT use can be safely reduced by eliminating its application in those children who are at very low risk of serious brain injuries.”

As part of the study, Kuppermann and his colleagues developed a set of rules for identifying low-risk patients who would not need a CT scan.

The “prediction rules” for children under two and for those two and older depends on the presence or absence of various symptoms and circumstances, including the way the injury was sustained and clinical evidence of skull fracture for both age groups.

The use of CT in patients who do not fall into the low-risk group identified by the prediction rules will depend on other factors, such as the physician’s experience, the severity and number of symptoms.

These findings appeared online in The Lancet.