• Abdullah Nour and Ran D Goldman.
• Can Fam Physician. 2022 Mar 1; 68 (3): 191193191-193.

QuestionA 1-year-old child presented to my clinic after falling from a couch and landing on his head. In the clinic, the child was asymptomatic and acting normally. Does this child need imaging of his head? If so, how do I decide between sending the child for a skull x-ray scan and sending him to the hospital for a computed tomography (CT) scan?AnswerThe Pediatric Emergency Care Applied Research Network clinical decision rule for CT scans helps identify children younger than 2 years of age at high risk of intracranial injury. Application of the rule, which has 100% sensitivity and 53.8% specificity for clinically important traumatic brain injury in children, is the first step to assessing children with minor head injury. If a CT scan is not needed urgently, it is recommended that children younger than 2 years get a skull x-ray scan only if a skull fracture is suspected. The presence and type of skull fracture can determine if a CT scan of the head and consultation with a neurosurgeon is warranted.Copyright© 2022 the College of Family Physicians of Canada.

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