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Child's Head Injury Doesn't Always Need CT Scan: Study
Date:5/9/2011

By John Leighty
HealthDay Reporter

MONDAY, May 9 (HealthDay News) -- Children rushed to emergency rooms with minor head trauma often get unneeded CT scans that expose them to high levels of radiation, a new study indicates.

Researchers analyzed the outcomes of more than 40,000 children treated for minor blunt head trauma at 25 U.S. emergency departments between June 2004 and September 2006. They found that four to six hours of clinical observation significantly reduced the use of cranial CT, a neuro-imaging test for traumatic brain injuries, without compromising care.

"There is an increased awareness that a CT scan is not always needed," said study co-leader Dr. Lise E. Nigrovic, of Children's Hospital Boston. "An effective strategy is observing the child's symptoms over time and, if they improve, don't do a CT."

Future studies will establish the appropriate length of observation to minimize the risk of missing a serious brain injury, Nigrovic said. The median age of the children in this study, published online May 9 in Pediatrics, was 5.6 years.

Nigrovic said many children show up in ERs with minor head trauma, but very few have significant traumatic brain injuries, identified as a condition resulting in death, brain surgery, use of oxygen tubes for more than 24 hours, or hospital admission for more than two days. She said monitoring symptoms is an effective strategy to reduce CT scans for children considered in the low- to intermediate-risk category.

"We use CT scans for high-risk cases because we don't want to miss a brain injury," said Nigrovic. "But if a 3-year-old girl with a headache or vomiting can stay in the ER and be monitored, and if after four hours the symptoms are gone, that's great. She can go home."

The ionizing radiation associated with CT scans has been associated with cancer, the authors note. Because their bodies are still developing, children are at greater risk tha
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