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Role of routine repeat head imaging in paediatric traumatic brain injury
Author(s) -
Bata Sonny C.,
Yung Michael
Publication year - 2014
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12582
Subject(s) - medicine , glasgow coma scale , traumatic brain injury , craniotomy , head injury , intracranial pressure , head trauma , retrospective cohort study , radiology , surgery , psychiatry
Background Paediatric traumatic brain injuries ( TBI ) remain a leading cause of morbidity and mortality in A ustralia. There are clear guidelines on head imaging for children with TBI , but there is conflicting evidence on the role of routine repeat head computed tomography ( CT ) scan. This study aims to determine whether routine repeat head CT scans in paediatric TBI alter surgical or medical management. Methods A retrospective study was performed at a level 1 tertiary paediatric trauma centre between J anuary 2002 and J uly 2012. Patients with TBI who were admitted with acute intracranial injury and at least one repeat head CT scan were included. Mechanism of injury, severity of TBI , G lasgow C oma S core, use of intracranial pressure monitoring and operative procedures were listed. The need for operative management was compared for routine and clinically indicated head scans. Results Routine head CT scan was done in 36 out of 71 patients (51%). None from this group required craniotomy, but two children (6%) needed delayed ICP monitoring. Three patients with moderate to severe TBI required intracranial pressure monitor or external ventricular drain insertion based on a clinically indicated repeat head CT . Conclusion Repeat head imaging is more likely to alter management of children with moderate to severe TBI . There is no role for routine repeat CT scan on mild TBI . Results of repeat cranial imaging should be correlated with the clinical status of the patient.