Beasley, Allen, Crow, Methvin, Portis & Miles, P.C.

Your 18-month toddler chases after a ball and hits her head on the edge of a table, knocking her to the ground. A softball hits your 12-year old athlete in the head, leaving a noticeable welt. Both of these seem like minor, albeit painful injuries, but you’ve seen reports on television and online that some seemingly innocuous bumps and minor concussions can lead to a deadly traumatic brain injury. What should you do?

Time, money, and x-ray radiation considered, it would be both unhealthy and nearly impossible to rush one’s children to the hospital for a CT scan every time they bump their heads. So is there a way to distinguish a simple bump from a serious head injury?

Researchers in the United States say than an analysis of more than 42,000 children with head injuries has helped uncover some guidelines to identify those who are at low risk for traumatic brain injury.

Of the tens of thousands of children examined, less than one percent (376) had some form of TBI, and of those, 60 had to undergo neurosurgery.

According to an article published in U.S. News & World Report, citing a study published in the medical journal The Lancet, there are visible signs that indicate whether children have a “clinically important” TBI. In children under two years old, “safe” signs are: “normal mental status, no scalp swelling except frontal, no loss of consciousness or unconscious for under five seconds, non-severe injury mechanism, no noticeable skull fracture, and parents reporting normal behavior in the child.”

“Using these guidelines, the researchers accurately predicted 100 percent of 1,176 patients who didn’t have clinically important traumatic brain injury,” the U.S. News report noted. “Among children under age 2 in this low-risk group, 24 percent received a CT scan,” according to the researchers cited in the article.

For children ages 2 to 18 years, the screening characteristics include: “normal mental status, no loss of consciousness, no vomiting, non-severe injury mechanism, no signs of basilar skull fracture, and no severe headache.”

According to the report, doctors correctly identified those children 2-18 years old without a clinically significant TBI using these characteristics in 99.95 percent of the cases.

The study’s author, Dr. Nathan Kupperman of the University of California, Davis Medical Center in Sacramento, said that “Using these clinically important traumatic brain injury prediction rules could have avoided the use of CT scans and resulting radiation exposure in 25 percent of children younger than 2 years old and in 20 percent of children older than 2 years.”

The full study may be viewed in the latest edition of The Lancet.

This entry was posted on Wednesday, September 16th, 2009 at 7:00 am and is filed under News. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.