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J Trauma Inj > Volume 28(3); 2015 > Article
Journal of Trauma and Injury 2015;28(3):149-157.
DOI: https://doi.org/10.20408/jti.2015.28.3.149    Published online September 30, 2015.
Value of Repeat Brain Computed Tomography in Children with Traumatic Brain Injury
Ho Jun Jo, Yong Su Lim, Jin Joo Kim, Jin Seong Cho, Sung Youl Hyun, Hyuk Jun Yang, Gun Lee
Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea. yongem@gilhospital.com
소아 두부외상 환자에서의 반복적인 두부 CT 검사의 유용성
조호준, 임용수, 김진주, 조진성, 현성열, 양혁준, 이근
가천대학교 길병원 응급의학과
Received: 13 August 2015   • Revised: 24 August 2015   • Accepted: 4 October 2015
Abstract
PURPOSE
Traumatic brain injury (TBI) is the most common cause of pediatric trauma patients came to the emergency department. Without guidelines, many of these children underwent repeat brain computed tomography (CT). The purpose of this study was to evaluate the value of repeat brain CT in children with TBI.
METHODS
We conducted a retrospective study of TBI in children younger than 19 years of age who visited the emergency department (ED) from January 2011 to December 2012. According to the Glasgow Coma Scale (GCS) and Pediatric Glasgow Coma Scale score of the patients, study population divided in three groups. Clinical data collected included age, mechanism of injury, type of TBI, and outcome.
RESULTS
A Total 83 children with TBI received repeat brain CT. There were no need for neurosurgical intervention in mild TBI (GCS score 13-15) group who underwent routine repeat CT. 4 patients of mild TBI group, received repeat brain CT due to neurological deterioration, and one patient underwent neurosurgical intervention. Routine repeat CT identified 12 patients with radiographic progression. One patient underwent neurosurgical intervention based on the second brain CT finding, who belonged to the moderate TBI (GCS score 9-12) group.
CONCLUSION
Our study showed that children with mild TBI can be observed without repeat brain CT when there is no evidence of neurologic deterioration. Further study is needed for establish indication for repetition of CT scan in order to avoid unnecessary radiation exposure of children.
Key Words: Traumatic brain injury; Pediatric; Repeat brain CT; Neurosurgical intervention; Glasgow Coma Scale


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