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Head Injury CT Indications in ChildrenAka: CT Head Indications in Pediatric Head Injury

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  1. See Also
    1. Head Injury CT Indications in Adults
    2. Head CT
    3. Head Injury
  2. General
    1. CT Head in all moderate and severe Head Trauma
    2. Guidelines below apply to minor Head Trauma only
      1. Blunt Head Trauma
      2. Patient remains awake and alert
  3. CT Head Indicated in all High Risk Patients
    1. Age under 3 months
      1. Younger children are less likely to be symptomatic
    2. Skull Fracture (intracranial injury in 15-30%)
      1. Scalp hematoma predicts Fracture (>80% sensitivity)
      2. Depressed skull Fracture
      3. Basilar skull Fracture
      4. New skull Fracture <24 hours
    3. Depressed mental status
    4. Focal neurologic deficits
    5. Bulging Fontanelle
    6. Irritability after Head Injury
    7. Less predictive "high risk" criteria
      1. Seizures
      2. More than 4 episodes of Vomiting after injury
      3. Loss of consciousness
  4. CT Head or Observation (>4-6 hours) in Intermediate Risk
    1. Three to four episodes of Vomiting after injury
    2. Transient loss of consciousness
    3. Initial irritability after injury that resolves
    4. Skull Fracture more than 24 hours old
    5. Behavior out of norm for child
  5. References
    1. Schutzman (2001) Pediatrics 107:983

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