• Timothy P Plackett, Sabrina Asturias, Matthew Tadlock, Franklin Wright, Hieu Ton-That, Demetrios Demetriades, Thomas Esposito, and Kenji Inaba.
• Division of Trauma, Surgical Critical Care, and Burns, Department of Surgery, Loyola University Medical Center, Maywood, IL, USA. Electronic address: tplacke@lumc.edu.
• J. Pediatr. Surg. 2015 Oct 1; 50 (10): 1758-61.

AbstractThere is no consensus on the optimal management of pediatric patients with suspected trauma brain injury and a normal head CT. This study characterizes the clinical outcomes of patients with a normal initial CT scan of the head. A retrospective chart review of pediatric blunt trauma patients who underwent head CT for closed head injury at two trauma centers was performed. Charts were reviewed for demographics, neurologic function, CT findings, and complications. 631 blunt pediatric trauma patients underwent a head CT. 63% had a negative CT, 7% had a non-displaced skull fracture, and 31% had an intracranial hemorrhage and/or displaced skull fracture. For patients without intracranial injury, the mean age was 8 years, mean ISS was 5, and 92% had a GCS of 13-15 on arrival. All patients with an initial GCS of 13-15 and no intracranial injury were eventually discharged to home with a normal neurologic exam and no patient required craniotomy. Not admitting those children with an initial GCS of 13-15, normal CT scan, and no other injuries would have saved 1.8 ± 1.5 hospital days per patient. Pediatric patients who have sustained head trauma, have a negative CT scan, and present with a GCS 13-15 can safely be discharged home without admission.Published by Elsevier Inc.

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