Pediatric minor head trauma: do cranial CT scans change the therapeutic approach?

Página do item simplificado
dc.citation.issue10
dc.citation.volume71
dc.contributor.authorAndrade, Felipe P.
dc.contributor.authorMontoro Neto, Roberto
dc.contributor.authorOliveira, Renan
dc.contributor.authorLoures, Gabriela
dc.contributor.authorFlessak, Luana
dc.contributor.authorGross, Roberta
dc.contributor.authorDonnabella, Camille
dc.contributor.authorPuchnick, Andrea [UNIFESP]
dc.contributor.authorSuzuki, Lisa
dc.contributor.authorRegacini, Rodrigo
dc.coverageSao Paulo
dc.date.accessioned2020-07-31T12:47:39Z
dc.date.available2020-07-31T12:47:39Z
dc.date.issued2016
dc.description.abstractOBJECTIVES: 1) To verify clinical signs correlated with appropriate cranial computed tomography scan indications and changes in the therapeutic approach in pediatric minor head trauma scenarios. 2) To estimate the radiation exposure of computed tomography scans with low dose protocols in the context of trauma and the additional associated risk. METHODS: Investigators reviewed the medical records of all children with minor head trauma, which was defined as a Glasgow coma scale >= 13 at the time of admission to the emergency room, who underwent computed tomography scans during the years of 2013 and 2014. A change in the therapeutic approach was defined as a neurosurgical intervention performed within 30 days, hospitalization, > 12 hours of observation, or neuro-specialist evaluation. RESULTS: Of the 1006 children evaluated, 101 showed some abnormality on head computed tomography scans, including 49 who were hospitalized, 16 who remained under observation and 36 who were dismissed. No patient underwent neurosurgery. No statistically significant relationship was observed between patient age, time between trauma and admission, or signs/symptoms related to trauma and abnormal imaging results. A statistically significant relationship between abnormal image results and a fall higher than 1.0 meter was observed (p=0.044). The mean effective dose was 2.0 mSv (0.1 to 6.8 mSv), corresponding to an estimated additional cancer risk of 0.05%. CONCLUSION: A computed tomography scan after minor head injury in pediatric patients did not show clinically relevant abnormalities that could lead to neurosurgical indications. Patients who fell more than 1.0 m were more likely to have changes in imaging tests, although these changes did not require neurosurgical interventionen
dc.description.abstracttherefore, the use of computed tomography scans may be questioned in this group. The results support the trend of more careful indications for cranial computed tomography scans for children with minor head trauma.en
dc.description.affiliationUniv Anhembi Morumbi, Lab Simulacao, Sao Paulo, SP, Brazil
dc.description.affiliationHosp Infantil Sabara, Dept Diagnost Imagem, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo UNIFESP, Dept Diagnost Imagem, Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo (UNIFESP), Departamento de Diagnóstico por Imagem, São Paulo/SP, Brazil
dc.description.sourceWeb of Science
dc.format.extent606-610
dc.identifierhttp://dx.doi.org/10.6061/clinics/2016(10)09
dc.identifier.citationClinics. Sao Paulo, v. 71, n. 10, p. 606-610, 2016.
dc.identifier.doi10.6061/clinics/2016(10)09
dc.identifier.fileS1807-59322016001000606.pdf
dc.identifier.issn1807-5932
dc.identifier.scieloS1807-59322016001000606
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56978
dc.identifier.wosWOS:000386579200009
dc.language.isoeng
dc.publisherHospital Clinicas, Univ Sao Paulo
dc.relation.ispartofClinics
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectComputed Tomographyen
dc.subjectMinor head traumaen
dc.subjectPediatricen
dc.subjectCT Scanen
dc.subjectRadiologyen
dc.titlePediatric minor head trauma: do cranial CT scans change the therapeutic approach?en
dc.typeinfo:eu-repo/semantics/article
Arquivos
Pacote Original
Agora exibindo 1 - 1 de 1
Imagem de Miniatura
Nome:
S1807-59322016001000606.pdf
Tamanho:
169.33 KB
Formato:
Adobe Portable Document Format
Descrição:
Baixar
Coleções
EPM - Artigos