CT scans may do more harm than good for kids with head injuries

by Aimee Keenan-Greene

A new study says watching and waiting may be the best medicine for kids with head injuries.

Scientists found clinical observation prior to conductingcomputed tomography (CT) for children with blunt head trauma could reduce unnecessary exposure to the long-term risks of CT radiation, while minimizing the risk of missing important injuries.

The Children's Hospital of Cincinnati says a CT scan, also called a CAT scan, uses x-rays to take pictures of the inside of a patient’s body. Most CT scans are about 10- 20 minutes in length.

Clinicians completed case report forms indicating whether the child was observed before making a decision regarding computed tomography. They defined clinically important traumatic brain injury as an intracranial injury resulting in death, neurosurgical intervention, intubation for longer than 24 hours, or hospital admission for 2 nights or longer. 
 
To compare computed tomography rates between children observed and those not observed before a decision was made regarding computed tomography use, they used a generalized estimating equation model to control for hospital clustering and patient characteristics.
 
Fourteen percent of the 5,433 patients were observed before making a decision on having a head CT).  
 
After adjusting for head injury severity, the CT rate was lower in observed patients than those not observed. Both groups had a similar traumatic brain injury rate. 

“The Effect of Observation on Head Computed Tomography Utilization for Children After Blunt Head Trauma,” was published online today and appears in the June 2011 issue of Pediatrics.

Another recent study says kids are getting more CT scans at the ER, and in turn more exposure to radiation.
The article in the April journal Radiology looked at the use of computed tomography (CT) in children visiting emergency departments between 1995 and 2008.

Chief complaints among those undergoing CT included head injury, abdominal pain, and headache.