Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Value of Repeat Brain Computed Tomography in Children with Traumatic Brain Injury

소아 두부외상 환자에서의 반복적인 두부 CT 검사의 유용성

  • Jo, Ho jun (Department of Emergency Medicine, Gachon University Gil Medical Center) ;
  • Lim, Yong Su (Department of Emergency Medicine, Gachon University Gil Medical Center) ;
  • Kim, Jin Joo (Department of Emergency Medicine, Gachon University Gil Medical Center) ;
  • Cho, Jin Seong (Department of Emergency Medicine, Gachon University Gil Medical Center) ;
  • Hyun, Sung Youl (Department of Emergency Medicine, Gachon University Gil Medical Center) ;
  • Yang, Hyuk Jun (Department of Emergency Medicine, Gachon University Gil Medical Center) ;
  • Lee, Gun (Department of Emergency Medicine, Gachon University Gil Medical Center)
  • 조호준 (가천대학교 길병원 응급의학과) ;
  • 임용수 (가천대학교 길병원 응급의학과) ;
  • 김진주 (가천대학교 길병원 응급의학과) ;
  • 조진성 (가천대학교 길병원 응급의학과) ;
  • 현성열 (가천대학교 길병원 응급의학과) ;
  • 양혁준 (가천대학교 길병원 응급의학과) ;
  • 이근 (가천대학교 길병원 응급의학과)
  • Received : 2015.08.13
  • Accepted : 2015.10.04
  • Published : 2015.09.30
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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.

Keywords

References

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