Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

EndNote Style
Original Article
Evaluation of brain computed tomography results in pediatric traumas
Aims: The use of brain computed tomography (CT) in the management of childhood head traumas is increasing every day. However, due to the more prominent harmful effects of radiation caused by CT in children and the increase in health expenditures, rules have been settled to determine brain CT indications, especially in children with mild head trauma. The aim of this study is to contribute to the literature by sharing the demographic characteristics, clinical findings and Brain CT results of pediatric patients who admitted to the emergency department (ED) with head trauma.
Methods: The study was conducted retrospectively in children who admitted to Kırıkkale University Hospital ED with head trauma. The demographic characteristics of the patients, their complaints at admission, Glasgow coma score (GCS), examination findings, follow-up and treatment management in the ED, and brain CT results were recorded. Chi-square test was used to compare the data. A value of p<0.05 was considered statistically significant.
Results: 234 children with head trauma were included in the study. Mean age of the study group was: 9.13±6.36 /years and 57.3% (n=134) were males. While 7.2% of the children were <2 years old, 92.8% of them were ?2 years old. Mean GCS was 14.92±0.79. Falling from a height was the most common cause of head trauma with 30.8%, followed by falling from the same level with 21.8% and in-vehicle traffic accident with 18.4%. Headache (37.2%), nausea-vomiting (36.8%) and loss of consciousness (13.7%) were the three most common admission symptoms after head trauma. Headache was found to be significantly higher in the ?2 age group and nausea-vomiting in the <2 age group compared to the other group (p=0.006; p<0.001, respectively). While 97.9% of brain CT results were normal, the most common pathological finding was linear fracture (2.1%). In terms of brain CT results, no difference was found between children <2 years and ?2 years of age (p=0.527).
Conclusion: Majority of the pediatric patients we evaluated in our study had minor head trauma, and most of the brain CT results were normal. Headache, nausea, vomiting, and loss of consciousness were the three most common symptoms after head trauma. Nausea-vomiting was observed more frequently in children aged <2 years and headache was observed inchildren aged ?2 years after head trauma, compared to other age groups.

1. Kidder K, Stein J, Frase J. The health of Canada&rsquo;s children. A CICH profile3rd ed. Ottawa (Ontario): Canadian Inst Child Health. 2000:81-102.
2. DiGuiseppi C, Roberts IG. Individual-level injury prevention strategies inthe clinical setting. Future Child. 2000;10:53-82.
3. Bowman SM, Bird TM, Aitken ME, Tilford JM. Trends in hospitalizationsassociated with pediatric traumatic brain injuries. Pediatrics. 2008;122:988-993.
4. National Center for Injury Prevention and Control: Webbased InjuryStatistics Query and Reporting System. Available at: http://webappa.cdc.gov/sasweb/ncipc/mortrate 10_sy.htlm.
5. http://www.cdc.gov/ncipc/wisqars (Accessed on July 14, 2020).
6. National Hospital Ambulatory Medical Care Survey: 2017 EmergencyDepartment Summary Tables http://cdc.gov/nchs/data/nhamcs/web_tables/2017_ed_web_tables-508.pdf (Accessed on July 14, 2020).
7. Kırış T, İş M, İmer M, G&uuml;le&ccedil; İ, Hepg&uuml;l K, &Uuml;nal F ve ark. N&ouml;roşir&uuml;rjideTravma Pratiği, Prospektif Epidemiyolojik &Ccedil;alışma. Ulus Travma Derg.1998;4(4):281-284.
8. Lyttle MD, Crowe L, Oakley E, Dunning J, Babl FE. Comparing CATCH,CHALICE and PECARN clinical decision rules for paediatric head injuries.Emerg Med J. 2012;29(10):785-794.
9. Dayan PS, Holmes JF, Schutzman S, et al. Traumatic Brain Injury StudyGroup of the Pediatric Emergency Care Applied Research Network(PECARN). Risk of traumatic brain injuries in children younger than 24months with isolated scalp hematomas. Ann Emerg Med. 2014;64(2):153-162.
10. Dayan PS, Holmes JF, Atabaki S, et al. Traumatic Brain Injury Study Groupof the Pediatric Emergency Care Applied Research Network (PECARN).Association of traumatic brain injuries with vomiting in children with blunthead trauma. Ann Emerg Med. 2014;63(6):657-665.
11. Diamond IR, Parkin PC, Wales PW, Bohn D, Kreller MA, Dykes EH.Preventable pediatric trauma deaths in Ontario: a comparative population-based study. J Trauma. 2009;66:1189-1195.
12. American College of Surgeons. Advanced trauma life supportr studentcourse manual. Chapter Ten. Pediatric trauma. 10th Edition. Chicago, IL.2018:186-214.
13. https://w w w.upto date.com/contents/minor-head-trauma-in-infants-and-children-management?search=Pediatric%20trauma%20management&amp;source=search_result&amp;selectedTitle=9~150&amp;usage_type=default&amp;display_rank=9
14. &Ccedil;elik Ş, G&uuml;ven-Kukul FM. Acil servise min&ouml;r kafa travması ile başvuran&ccedil;ocukların retrospektif değerlendirilmesi. Anatolian J Emerg Med.2020;3(1);14-17.
15. Atmış A, Tolunay O, &Ccedil;elik T, et al. Dilemma in pediatric head trauma: ıscranial computed tomography necessary or not in minor head traumas? JPediatr Emerg Intensive Care Med. 2016;(3):27-31.
16. Y&uuml;ceer N, Mertol T, Arda MN. Kafa travmalı 106 &ccedil;ocuk olgunun klinikdeğerlendirme sonu&ccedil;ları. D&uuml;ş&uuml;nen Adam. 2005;(18):95-100.
17. Işık A, G&ouml;kyar A, Yıldız &Ouml;, Bostancı U, &Ouml;zdemir C: &Ccedil;ocukluk &ccedil;ağı kafatravmaları, 851 olgunun retrospektif değerlendirilmesi: Epidemiyolojik bir&ccedil;alışma. Ulus Travma Acil Cerrahi Derg. 2011;17(2):166-172.
18. Al B, Yildirim C, Coban S. Falls from heights in and around the city ofBatman. Ulus Travma Acil Cerrahi Derg. 2009;15:141-147.
19. G&uuml;zel A, Ceylan A, Tatli M, Başoğul M, Ozer N, Kahraman R. Falls fromheight in childhood in Diyarbakir province: a questionnaire study combinedwith clinical data. Ulus Travma Acil Cerrahi Derg. 2009;15:277-284.
20. Lallier M, Bouchard S, St-Vil D, Dupont J, Tucci M. Falls from heightsamong children: a retrospective review. J Pediatr Surg. 1999;34(7):1060-1063.
21. Melo JR, Di Rocco F, Lemos-J&uacute;nior LP, Roujeau T, Th&eacute;lot B, Sainte-Rose C.Defenestration in children younger than 6 years old: mortality predictors insevere head trauma. Childs Nerv Syst. 2009;25:1077-1083.
22. Schutzman SA, Greenes DS. Pediatric minor head trauma. Ann Emerg Med.2001;37(1): 65-74.
23. Geyik AM, Doku M. &Ccedil;ocuklarda hafif kafa travmaları. T&uuml;rk N&ouml;roşirurjiDerg. 2013; 23(2):117-23.
24. Babl FE, Borland ML, Phillips N, et al. Paediatric Research in EmergencyDepartments International Collaborative (PREDICT). Accuracy ofPECARN, CATCH, and CHALICE head injury decision rules in children: aprospective cohort study. Lancet. 2017;389(10087): 2393-2402.
25. https://www.mdedge.com/emergencymedicine/article/154425/trauma/playing-rules-using-decision-rules-wisely-part-1-trauma/page/0/2
26. Carroll LJ, Cassidy JD, Peloso PM, et al. Prognosis for mild traumatic braininjury: Results of the WHO Collaborating Centre Task Force on MildTraumatic Brain Injury. J Rehabil Med. 2004;(43 suppl):84-105.
27. Da Dalt L, Andreola B, Facchin P, et al. Characteristics of children withvomiting after minor head trauma: A case-control study. J Pediatr.2007;150(3):274-278.
28. Dietrich AM, Bowman MJ, Ginn-Pease ME, Kosnik E, King DR. Pediatrichead injuries: Can clinical factors reliably predict an abnormality oncomputed tomography? Ann Emerg Med. 1993;22(10):1535-1540.
29. Duhaime AC, Alario AJ, Lewander WJ, et al. Head injury in very youngchildren: Mechanisms, injury types, and ophthalmologic findings in 100hospitalized patients younger than 2 years of age. Pediatrics. 1992;90(2):179-185.
Volume 3, Issue 2, 2023
Page : 95-99