NEW YORK May 10 (Reuters Life!) - Observing some children
after a head injury may help reveal which ones need a computed
tomography (CT) scan and which ones don't, enabling many to
avoid the radiation of an unnecessary test, according to a U.S.
This is particularly true for children who have some risk of
a serious brain injury, but aren't showing serious symptoms,
said Lise Nigrovic at Children's Hospital, Boston, who worked on
If a child shows up at an emergency room very soon after a
head injury, "you may just not have had enough time for symptoms
to develop," she told Reuters Health.
Or a child "may have some symptoms that make you a little
concerned, but you just want a little time."
Nigrovic and her colleagues reviewed data on over 40,000
children with a head injury who were taken to one of 25
different emergency rooms.
The original data had been collected by the Pediatric
Emergency Care Applied Research Network, with chart notes
showing whether each child was admitted for observation before
doctors decided whether or not to perform a CT scan.
About 5,400, or 1 in 7, were observed. They were less likely
to get a CT scan, 31 percent against 35 percent when doctors
made that decision right away.
In both groups, fewer than 1 percent had a serious head
Twenty-six children who were observed and sent home without
a CT scan came back later for an x-ray. One of those children
did end up having a positive scan.
The researchers concluded that observing some children
before making the decision about a CT scan might be a safe and
effective way of cutting back on scans, giving the example of a
child who fell off a swing, had a headache and vomited once, but
were awake and talking two hours after the injury.
"We all want to make sure that we use CT scanning in the
cases where it's likely to be positive and that we save children
from the radiation for those that we know are very unlikely to
be positive," said Martin Osmond, at the Children's Hospital of
Eastern Ontario, who had no ties to the study.
"This study adds important new information about who to
But he added that a few questions remain, such as how long
it makes sense to observe children before deciding whether to do
a CT scan or send them home. There are also questions about how
safe it is to put off such a scan, which will need to be the
focus of future research.
(Reporting by Genevra Pittman at Reuters Health; editing by