Can a CT be Omitted in Pediatric Minor Head Trauma?: A Comment

Can a CT be Omitted in Pediatric Minor Head Trauma?: A Comment

We read the article on “Can a CT be Omitted in Pediatric Minor Head Trauma?” with great interest.[1] Arneitz et al concluded that “neuro-observation without initial computed tomography (CT) scans is safe in infants and children following minor head trauma. Special pediatric CT protocol can limit radiation exposure.”[1] Indeed, the indication for using CT in pediatric minor head trauma is a widely discussed issue. A positive finding is not uncommon, but it can usually be managed by conservative treatment.[2] Based on the data provided by Arneitz et al, it seems that the investigation can be skipped. Nevertheless, there are many factors to be addressed. First, the definition of minor head trauma has to be well defined. This is usually a difficult issue in clinical practice. “How to judge, whether the injury is serious or not” is usually a big problem. In addition, it is hard to rule out the case with possible unknown underlying medical disorder (such as thromobohemostatic disorders) that requires good investigation for silent bleeding. Systematic risk and benefit of the CT in different settings with different epidemiology of pediatric head trauma is recommended for finalized conclusion on this topic.

• References

• 1 Arneitz C, Sinzig M, Achatz E, Fasching G. Can a CT be omitted in pediatric minor head trauma?. J Pediatr Neurol DOI: 10.1055/s-0037-1604420.
• 2 Andrade FP, Montoro R, Oliveira R. , et al. Pediatric minor head trauma: do cranial CT scans change the therapeutic approach?. Clinics (Sao Paulo) 2016; 71 (10) 606-610