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AAP Grand Rounds 4:31-32 (2000)
© 2000 American Academy of Pediatrics

EMERGENCY MEDICINE

Who Needs CT Scans After Minor Head Injury?

Source: Haydel MJ, Preston CA, Mills TJ, et al. Indications for computed tomography in patients with minor head injury. N Engl J Med. 2000;343:100–105.

The first 20% of the full text of this article appears below.

CT scans are commonly used in the emergency department (ED) to evaluate not only severe head trauma but also to detect intracranial injury in patients with less severe head trauma. However, the utility of routine CT scanning in patients with minor head trauma is controversial for both child and adult patients. Haydel et al sought to develop and validate clinical criteria to identify patients with minor head injury who do not benefit from CT scans. Patients 3 years and older who presented to the ED at Charity Hospital, New Orleans, LA, within 24 hours after trauma were eligible for inclusion. Minor head injury was defined as witnessed loss of consciousness or amnesia of the traumatic event in patients with a normal brief neurologic examination and a normal Glasgow Coma Scale score of 15 upon arrival to the ED. Those who declined the CT scan, had concurrent injury that precluded the use of CT, or reported no loss of consciousness or amnesia of the traumatic event were excluded.

The initial phase of the study used a . . . [Full Text of this Article]

Jeffrey R. Avner, MD, FAAP
Pediatric Emergency Medicine, Albert Einstein College of Medicine, Bronx, NY