Evaluation of infants undergoing cranial computed tomography in the emergency department due to head trauma

Year 2019, Volume: 1 Issue: 3, 111 - 114, 23.12.2019

Ramazan Ünal , Dilek Atik Ahmet Erdur , Bensu Bulut , Hasan Çam Salih Fettahoğlu Ramazan Güven , Başar Cander

Abstract

Pediatric head trauma is one of the most important
public health issues worldwide and is one of the most common causes of
morbidity and mortality in this age group. In infants, trauma of the same
severity with adults bring different outcomes as the body structure is
different compared to adults. Imaging methods are frequently used in infants
presenting with trauma, since children in the 0-2 age group cannot express
themselves, their neurological examination is limited and families of infants
cannot provide clear information about trauma. 
The best imaging method for trauma is cranial computed tomography (CCT).
In this study, patients aged 0-2 years who applied to an emergency department
of a training and research hospital in Istanbul between January 1, 2018 and
January 31, 2018 were examined retrospectively. The aim of this study was to
determine a clinical pathway by evaluating cranial computed tomography imagings
of 0-2 year-old pediatric patients brought to the emergency department for head
trauma. In our study, 523 patients aged 0-2 years were admitted for trauma
between the specified time period and 166 of these patients underwent CCT. Of
the patients who underwent CCT, 9% (n=15) were found to have pathology due to
trauma. Ten of these patients underwent follow-up CCT.  One of 15 patients was found to have bone
fracture. The other 14 patients were suspected of contusion. Of the patients
who underwent CCT, 3.1% (n=5) were admitted to the ward for follow-up.

When the patients were evaluated in terms of clinical
course, hospitalization or discharge in our study, they were found to correlate
with pathologies detected on CCT.

Due to the intensity of the patients in the emergency
department, sufficient time cannot be allocated for the examination and
informing of patients. It was observed that Cranial CT request frequency
increased especially between 16: 00-00: 00 hours when emergency department
intensity increased.

In infant trauma patients, imaging studies should be
determined considering the severity and mechanism of trauma.

Keywords

head trauma, infant, computed tomography, emergency department

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