Incidental Findings on Computed Tomography Scans in Children With Mild Head Trauma

• Published in: Clinical pediatrics Vol. 51; no. 9; pp. 872 - 876
• Main Authors: Ortega, Henry W., Vander Velden, Heidi, Reid, Samuel
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-09-2012; Westminster Publications, Inc
• Subjects: Adolescent; Brain Injuries - complications; Brain Injuries - diagnostic imaging; Child; Child, Preschool; Children & youth; Emergency medical care; Emergency Service, Hospital; Female; Head injuries; Head Injuries, Closed - complications; Head Injuries, Closed - diagnostic imaging; Humans; Incidental Findings; Infant; Infant, Newborn; Male; Medical treatment; Pediatrics; Retrospective Studies; Tomography; Tomography, X-Ray Computed; computed tomography; closed head injury; incidental findings; pediatric
• ISSN: 0009-9228; 1938-2707
• DOI: 10.1177/0009922812450508

Background
Computed tomography (CT) scans are frequently used in managing traumatic brain injuries in children.
Objective
To assess incidental findings in children with head trauma undergoing CT scan and to describe any associated clinical ramifications.
Materials and methods
Retrospective review of 524 children treated in 2 emergency departments for closed head injury who received a CT scan.
Results
Overall, 137 (26.2%) patients had an incidental finding on CT scan. The most common incidental finding was sinus opacification with an air fluid level (115/137, 83.9%). Thirty-five interventions were reported in children with incidental findings. Children 2 years old or younger were more likely to receive a prescription for antibiotics (relative risk [RR] = 2.66, 95% confidence interval [CI] = 1.08-6.51) and be referred to a specialist (RR = 10.26, 95% CI = 3.56-29.56) than older children.
Conclusion
Incidental findings in minor head trauma are common. Clinicians should be prepared to address these findings if clinically indicated.