Abstract:

Aim: In this study, we aimed to assess how the routine use of a second head computed tomography (CT) scan contributed to therapeutic approach in children diagnosed with mild traumatic brain injury (TBI). Methods: The retrospective study included children with mild TBI who had traumatic lesions on initial head CT and underwent a second CT scan as performed routinely at our pediatric emergency department between August 2010 and August 2014. Patient data (age and sex, mechanism of trauma, symptoms, physical examination findings, results of the first and second head CT scans, time between the two scans, and medical and surgical treatments) were recorded. Results: A total of 113 patients met the inclusion criteria and 57.5% of them were male. The median patient age was 28 (interquartile range: 6.5–80) months. Seventy-two (63.7%) patients were asymptomatic on admission and there was no finding on physical examination in 54 (47.8%) patients. Of all traumatic lesions, 64.9% were linear skull fracture, 13.7% subdural hematoma, 13% contusion, 3.8% subarachnoid hemorrhage, 3% epidural hematoma, 0.8% intraparenchymal hemorrhage, and 0.8% depressed skull fracture. The routine second head CT scans were performed after 11±2.5 hours and revealed progression in 6.2% of the patients. No subsequent change in medical treatment or neurosurgical intervention occurred. Conclusion: Although the progression rate in routinely repeated CT at our emergency department was 6.2%, there was no change in the medical and neurosurgical interventions performed.

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