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Research provides new guidelines to identify children with mild injuries and reduce radiation exposure.

A substantial percentage of children who get CT scans after apparently minor head trauma do not need them, and as a result are put at increased risk of cancer due to radiation exposure. After analyzing more than 42,000 children with head trauma, a national research team led by two UC Davis emergency department physicians has developed guidelines for doctors who care for children with head trauma aimed at reducing those risks. Their findings appear in an article published online today and in an upcoming edition of The Lancet.

The collaborative study includes data collected at 25 hospitals from children who were evaluated for the possibility of serious brain injury following trauma to the head. Researchers found that one in five children over the age of 2 and nearly one-quarter of those under 2 who received CT scans following head trauma did not need them because they were at very low risk of having serious brain injuries. In these low-risk children, the risk of developing cancer due to radiation exposure outweighed the risk of serious brain injury.

As part of the study, Kuppermann and his colleagues developed a set of rules for identifying low-risk patients who would not need a CT. The "prediction rules" for children under 2 and for those 2 and older depend on the presence or absence of various symptoms and circumstances, including the way the injury was sustained, a history of loss of consciousness, neurological status at the time of evaluation and clinical evidence of skull fracture for both age groups. The use of CT in patients who do not fall into the low-risk group identified by the prediction rules will depend on other factors, such as the physician's experience, the severity and number of symptoms, and other factors.

Source: UC Davis Health System

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