Risk factors for abnormal CT findings in preschool children head injuries without neurological deficit

Lee, Dong Kou; Park, Dong Chan; Lee, Je Won; Choe, Jae Young; Kim, Chang Ho

J Korean Soc Emerg Med > Volume 32(3); 2021 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2021;32(3): 214-221.

Risk factors for abnormal CT findings in preschool children head injuries without neurological deficit

¹Department of Emergency Medicine, Daegu Fatima Hospital, Daegu, Korea
²Department of Emergency Medicine, Kyungbook National University Hospital, Daegu, Korea

Correspondence

Chang Ho Kim ,Tel: 053-200-2100, Fax: 053-422-1277, Email: 9754130@hanmail.net,

Received: May 8, 2020; Revised: July 20, 2020 Accepted: August 31, 2020. Published online: June 30, 2021.

ABSTRACT

Objective:
This study aimed to apply abnormal computed tomography (CT) findings to help identify clinical and physical characteristics which suggest a traumatic brain injury, in preschool children with mild head injuries but without neurological deficit.
Method:
Among the 1,735 preschool children (aged ≤6 years) with head trauma who visited our hospital and underwent CT scans, 1,711 students without severe neurologic deficits were retrospectively assessed via images and electronic records. The relationship between the occurrence of abnormal CT findings and clinical symptoms, physical examination findings, and the conditions of children were assessed using Pearson’s chi-squared test and multivariable logistic regression analysis.
Results:
Traumatic brain injury with abnormal CT findings were observed in 75 of the 1,711 patients, and the association with brain injury was more prominent among patients who had fallen from a height of ≥1 m, had posttraumatic irritability, or had posttraumatic scalp swelling.
Conclusion:
Free fall from a height of ≥1 m, posttraumatic irritability, and posttraumatic scalp swelling should be carefully assessed in patients who have suffered a traumatic brain injury and show abnormal CT findings but no neurologic deficits. Regardless of their initial signs, an active test is recommended for children who complain of multiple symptoms. Patients with these risk factors require greater in-depth brain CT examination. Abnormal CT findings are more meaningful in the case of patients with multiple symptoms.

Key words: Brain injury; Trauma; Pediatric; Computed tomography; Risk factor