Neuroimaging for paediatric minor closed head injuries

It is clear that paediatric minor head injuries are common and that most cases may be observed without neuroimaging. However, with easier access to computed tomography scans, there has been an increase in its use. In the present article, clinical decision rules for neuroimaging of paediatric minor head injuries, such as the Child and Adolescent Trial for Cardiovascular Health (CATCH) study, will be discussed. Risk factors that should trigger concern are persistently low Glasgow coma scale, suspected open or basilar skull fracture, worsening headache, irritability, large and boggy scalp hematomas and dangerous mechanism of injury. An update on recent recommendations and evidence-based changes are provided.