Abstract
Head trauma is one of the most common reasons for children to visit the emergency
room in the United States. Computed tomography (CT) utilization for pediatric head
trauma continues to increase despite public concern regarding ionizing radiation exposure.
More than 90% of the imaging studies in children with minor head trauma are negative
for traumatic brain injuries (TBIs). Judicious use of head CT is important to reduce
unnecessary ionizing radiation in the vulnerable pediatric population. With the goal
of reducing unnecessary CT for pediatric TBI patients, an important question is not
“who needs head CT” but “who can safety avoid head CT.” When abnormal CT findings
are present for moderate or severe TBI patients, accurate and reproducible scoring
systems are also necessary to make CT reports actionable and meaningful for physicians
in the trauma team. This article outlines the current evidence-based practices for
pediatric head CT use, highlighting relevant clinical decision-making tools, as well
as reviews the current CT-based trauma scoring systems.
Keywords
head trauma - pediatric head trauma - traumatic brain injury - head CT - noncontrast
CT - PECARN
