PERSPECTIVE
Head injury
Skull x rays, CT scans, and making a decision in head injury
Correspondence to:
Correspondence to:
Dr Robert C Tasker
Department of Paediatrics, University of Cambridge Clinical School, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK; rct31@cam.ac.uk
Commentary on the paper by Reed et al (see page 859)
Keywords: brain injury; head trauma
| The first 150 words of the full text of this article appear below. |
Over the last year the problem of radiological investigation of the acutely head injured child has been much featured in this journal. We were not so much concerned with what to do with the severely injured—such children are, invariably, intubated and mechanically ventilated, and the most pressing question is to identify whether they need immediate surgery. Head computed tomography (CT) is the obvious investigation. Rather, the real problem arises in the uncooperative 1 to 8 year old who just won’t lie still long enough for CT—is it really worth getting one even if it means endotracheal intubation and a brief anaesthetic, or will a skull x ray suffice, or should the child be admitted for observation until we are sure all is well?
Dunning et al reviewed 16 previously published papers and provided us with a meta-analysis of variables that predict significant intracranial injury in minor head trauma.1
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- Can we abolish skull x rays for head injury?
- M J Reed, J G Browning, A G Wilkinson, and T Beattie
Arch. Dis. Child. 2005 90: 859-864.[Abstract] [Full Text] [PDF]
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