J Korean Soc Emerg Med.  2021 Jun;32(3):214-221.

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

• Lee DK
• Park DC
• Lee JW
• Choe JY
• Kim CH

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.
Methods
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.

Keyword

Brain injury; Trauma; Pediatric; Computed tomography; Risk factor