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Diagnostic approach to children with minor traumatic brain injury

Wien Med Wochenschr. 2012 Sep;162(17-18):394-399. Epub 2012 Jul 14.Diagnostic approach to children with minor traumatic brain injury.

Source Section Neuropediatrics, University Children's Hospital of Saarland, Homburg, Germany.

Abstract: STUDY PURPOSE:To analyse the management of minor traumatic brain injury (MTBI) in paediatric hospitals in Germany.

METHODS:An electronic survey was sent to 72 children hospitals.

RESULTS:All participating (45/72; 62.5 %) hospitals had facilities to perform an electroencephalogram (EEG), 98 % cranial ultrasonography, 94 % MRI studies, and 87 % a CT scan. The initial Glasgow Coma Scale, the clinical presentation/neurological deficits, the intensity of the trauma and external/visible injuries were most important for initial assessment. The main reason for in-patient monitoring was initial clinical neurologic presentation (44 %). X-ray scans were used routinely in only 2.2 %, cMRI scans in 6.7 % and cCT scans in 13.3 %; approximately one third employed ultrasonography. In 22.2 % was an EEG part of the routine diagnostic work-up. Inpatient monitoring for 24-48 h was done in 80 %.

CONCLUSIONS:Children with MTBI are often monitored clinically without resorting to potentially harmful and expensive diagnostic procedures (cCT scans).




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