Observational analysis reveals CT criteria effectiveness in children with mild TBI, indicating importance of protocols.
INTRODUCTION: To avoid inappropriate exposure to computed tomography (CT) radiation, protocols guiding medical decision-making for this examination are used for children who have suffered mild traumatic brain injury (TBI). Therefore, the objective of this study was to evaluate the criteria for CT indication in children with mild TBI in the emergency department of a high-complexity hospital. METHODS: In this study, epidemiological and clinical data were collected from 328 medical records of children under 14 years old diagnosed with mild TBI who underwent CT scans. Additionally, the Pediatric Emergency Care Applied Research Network (PECARN) protocol was applied to determine whether or not a CT should be performed. RESULTS: Analysis of the collected data revealed that 55.8% were male, with a mean age of 2 years. Most accidents occurred in residential settings, and the main symptoms presented were vomiting, drowsiness, excessive crying, and loss of consciousness. 34.5% of CT scans were indicated by PECARN, with 5.2% of patients showing TC abnormalities. CONCLUSION: This study identified that male children were more affected by TBI, with a median age of 2 years. Few patients exhibited symptoms, and the most prevalent one was vomiting. Of all exams performed, the PECARN protocol indicated only one-third of them. Furthermore, only 5.2% of the scans showed abnormalities. Lastly, those aged < 3 years with CT indication by the protocol had the highest rate of abnormalities on CT.
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Signor et al. (2025) studied this question.
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