Children With Mild Head Injuries Are Still Getting Too Many Brain Scans
By: Nina Shapiro
One of the worst fears parents have is getting a call from school, from a coach, from highway patrol, or even witnessing themselves that their child suffered a head injury. While more protective headgear during sports and child safety seats in cars has resulted in a decrease in the numbers of severe head injuries on playing fields and in motor vehicle accidents, head injuries in children continue to be a concern, not only in frequency, but in how to manage them. Traumatic Brain Injury (TBI) has become increasingly recognized in children, specifically regarding the need for better monitoring following concussions. A large portion of children with mild head injuries are seen by their primary care doctors, avoiding unnecessary visits to emergency rooms. However, TBI continues to be an issue, and its management has more recently become an area of study. A recent article looked at data from the National Hospital Ambulatory Care Medical Survey databases from 2007-2015, obtaining a representative sample of children under age 18 years visiting emergency departments for head injuries. Of the 14.3 million children studied, 32% underwent CT (computed tomography) scans of the brain if being evaluated for a head injury. These included those with injuries ranging from minor, without loss of consciousness, to major, with severe neurologic damage. There have been many initiatives over the past decade in providing better guidelines to tailor needs of children based on severity of injury, as the vast majority of children with minor or moderate TBI, even with signs of concussion, do not need CT scans. Despite many educational efforts, the 32% rate of CT scans for pediatric head injuries did not decline during the nine-year study period.
Dr. Christopher Giza, director of the UCLA Steve Tisch BrainSPORT Program, has several potential explanations [Read More…]