Soft-tissue evidence of head injury in infants and young children: is CT head examination justified?
Aim To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5 cm following head injury in children presenting to a paediatric accident and emergency (A&E) depart...
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| Veröffentlicht in: | Clinical radiology 2017-04, Vol.72 (4), p.316-322 |
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| creator | Zaman, S Logan, P.H Landes, C Harave, S |
| description | Aim To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5 cm following head injury in children presenting to a paediatric accident and emergency (A&E) department in the northwest of England. Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring 1 year with evidence of soft-tissue injury, but without any other concerning feature. Materials and methods Children |
| doi_str_mv | 10.1016/j.crad.2016.12.012 |
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Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring <5 cm, or for children >1 year with evidence of soft-tissue injury, but without any other concerning feature. Materials and methods Children <3 years of age presenting with soft-tissue evidence of head injury between May 2011 and Oct 2014 and who subsequently underwent head CT were retrospectively identified from radiology requests. The CT images and clinical notes were used to identify those with skull fracture or intracranial haemorrhage and to determine whether the child was subsequently admitted or discharged from A&E. Results Eighty-five CT head examinations met the criteria for inclusion. Of these, 45 examinations demonstrated skull fractures and four examinations identified intracranial haemorrhage. Thirty-eight requests included soft-tissue evidence of head injury as the sole reason indicated for CT head examination. Of these, 22 examinations demonstrated skull fractures and one examination identified intracranial haemorrhage. Conclusion Soft-tissue evidence of head injury as the sole reason for CT head examination appears to be justified in the present patient population. Furthermore, this study suggests that CT head examination should also be considered for children with soft-tissue injuries of <5 cm and for children aged between 1 and 3 years if identification of a skull fracture would alter the child's management.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2016.12.012</identifier><identifier>PMID: 28118993</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Child, Preschool ; Craniocerebral Trauma - complications ; Craniocerebral Trauma - diagnostic imaging ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Radiology ; Retrospective Studies ; Skull Fractures - complications ; Skull Fractures - diagnostic imaging ; Soft Tissue Injuries - complications ; Tomography, X-Ray Computed - methods</subject><ispartof>Clinical radiology, 2017-04, Vol.72 (4), p.316-322</ispartof><rights>The Royal College of Radiologists</rights><rights>2017 The Royal College of Radiologists</rights><rights>Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-2e922f1cf9afbe6ee2dab39b3ba0ea2b0d325366c3cd79f28bfcd87f138b2d5c3</citedby><cites>FETCH-LOGICAL-c411t-2e922f1cf9afbe6ee2dab39b3ba0ea2b0d325366c3cd79f28bfcd87f138b2d5c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0009926017300065$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28118993$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zaman, S</creatorcontrib><creatorcontrib>Logan, P.H</creatorcontrib><creatorcontrib>Landes, C</creatorcontrib><creatorcontrib>Harave, S</creatorcontrib><title>Soft-tissue evidence of head injury in infants and young children: is CT head examination justified?</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>Aim To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5 cm following head injury in children presenting to a paediatric accident and emergency (A&E) department in the northwest of England. Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring <5 cm, or for children >1 year with evidence of soft-tissue injury, but without any other concerning feature. Materials and methods Children <3 years of age presenting with soft-tissue evidence of head injury between May 2011 and Oct 2014 and who subsequently underwent head CT were retrospectively identified from radiology requests. The CT images and clinical notes were used to identify those with skull fracture or intracranial haemorrhage and to determine whether the child was subsequently admitted or discharged from A&E. Results Eighty-five CT head examinations met the criteria for inclusion. Of these, 45 examinations demonstrated skull fractures and four examinations identified intracranial haemorrhage. Thirty-eight requests included soft-tissue evidence of head injury as the sole reason indicated for CT head examination. Of these, 22 examinations demonstrated skull fractures and one examination identified intracranial haemorrhage. Conclusion Soft-tissue evidence of head injury as the sole reason for CT head examination appears to be justified in the present patient population. Furthermore, this study suggests that CT head examination should also be considered for children with soft-tissue injuries of <5 cm and for children aged between 1 and 3 years if identification of a skull fracture would alter the child's management.</description><subject>Child, Preschool</subject><subject>Craniocerebral Trauma - complications</subject><subject>Craniocerebral Trauma - diagnostic imaging</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Skull Fractures - complications</subject><subject>Skull Fractures - diagnostic imaging</subject><subject>Soft Tissue Injuries - complications</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-LFDEQxYMo7rj6BTxIjl66TVWmezoiLjL4DxY87AreQjqpuGl70mvSvTjf3jSzevAgFFQVvPegfsXYcxA1CGhfDbVNxtVY5hqwFoAP2AZk21SI6ttDthFCqEphK87Yk5yHdd3i9jE7ww6gU0pumLua_FzNIeeFON0FR9ESnzy_IeN4iMOSjqWV8ibOmZvo-HFa4ndub8LoEsXXPGS-vz4Z6Jc5hGjmMEU-LHkOPpC7eMoeeTNmenbfz9nXD--v95-qyy8fP-_fXVZ2CzBXSArRg_XK-J5aInSml6qXvRFksBdOYiPb1krrdspj13vrup0H2fXoGivP2ctT7m2afi6UZ30I2dI4mkjTkjV0LXQNSAVFiiepTVPOiby-TeFg0lGD0CtdPeiVrl7pakBd6BbTi_v8pT-Q-2v5g7MI3pwEVK68C5R0tmEl6kIiO2s3hf_nv_3HbscQgzXjDzpSHqYlxcJPg87FoK_Wh67vhZ0sY9vI3zZLoZg</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Zaman, S</creator><creator>Logan, P.H</creator><creator>Landes, C</creator><creator>Harave, S</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170401</creationdate><title>Soft-tissue evidence of head injury in infants and young children: is CT head examination justified?</title><author>Zaman, S ; Logan, P.H ; Landes, C ; Harave, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-2e922f1cf9afbe6ee2dab39b3ba0ea2b0d325366c3cd79f28bfcd87f138b2d5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Child, Preschool</topic><topic>Craniocerebral Trauma - complications</topic><topic>Craniocerebral Trauma - diagnostic imaging</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Skull Fractures - complications</topic><topic>Skull Fractures - diagnostic imaging</topic><topic>Soft Tissue Injuries - complications</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zaman, S</creatorcontrib><creatorcontrib>Logan, P.H</creatorcontrib><creatorcontrib>Landes, C</creatorcontrib><creatorcontrib>Harave, S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zaman, S</au><au>Logan, P.H</au><au>Landes, C</au><au>Harave, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Soft-tissue evidence of head injury in infants and young children: is CT head examination justified?</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>72</volume><issue>4</issue><spage>316</spage><epage>322</epage><pages>316-322</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><abstract>Aim To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5 cm following head injury in children presenting to a paediatric accident and emergency (A&E) department in the northwest of England. Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring <5 cm, or for children >1 year with evidence of soft-tissue injury, but without any other concerning feature. Materials and methods Children <3 years of age presenting with soft-tissue evidence of head injury between May 2011 and Oct 2014 and who subsequently underwent head CT were retrospectively identified from radiology requests. The CT images and clinical notes were used to identify those with skull fracture or intracranial haemorrhage and to determine whether the child was subsequently admitted or discharged from A&E. Results Eighty-five CT head examinations met the criteria for inclusion. Of these, 45 examinations demonstrated skull fractures and four examinations identified intracranial haemorrhage. Thirty-eight requests included soft-tissue evidence of head injury as the sole reason indicated for CT head examination. Of these, 22 examinations demonstrated skull fractures and one examination identified intracranial haemorrhage. Conclusion Soft-tissue evidence of head injury as the sole reason for CT head examination appears to be justified in the present patient population. Furthermore, this study suggests that CT head examination should also be considered for children with soft-tissue injuries of <5 cm and for children aged between 1 and 3 years if identification of a skull fracture would alter the child's management.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28118993</pmid><doi>10.1016/j.crad.2016.12.012</doi><tpages>7</tpages></addata></record> |
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| ispartof | Clinical radiology, 2017-04, Vol.72 (4), p.316-322 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Child, Preschool Craniocerebral Trauma - complications Craniocerebral Trauma - diagnostic imaging Female Humans Infant Infant, Newborn Male Radiology Retrospective Studies Skull Fractures - complications Skull Fractures - diagnostic imaging Soft Tissue Injuries - complications Tomography, X-Ray Computed - methods |
| title | Soft-tissue evidence of head injury in infants and young children: is CT head examination justified? |
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