Emergency docs too quick to order CT scans for kids' head injuries, study suggests

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(CBS) When kids get conked on the noggin, many emergency doctors are quick to order a CT scan to rule out traumatic brain injury (TBI) - often at the urging of worried parents. But a new study suggests that approach may be bad medicine.

Why is that? Because in addition their high cost, CT scans expose kids to ionizing radiation that may increase the risk of developing cancer down the road.

"Only a small percentage of children with blunt head trauma really have something serious going on," study co-author Dr. Lise Nigrovic of Children's Hospital Boston, said in a written statement released in conjunction with the study. "If you can be watched in the emergency department for a few hours, you may not need a CT."

The multi-center study - published in the June 2001 issue of the journal Pediatrics - involved more than 40,000 children with blunt head trauma. It showed that by taking a little extra time to observe kids, doctors can halve the number of CT scans these kids receive without putting kids at any additional risk.

And fewer CT scans mean kids' lifetime risk for cancer may be lowered. Because their brains are still growing, kids are believed to be more vulnerable to radiation.

Just what are doctors supposed to look for during the observation period? Headache, vomiting, and confusion top the list. And any change in symptoms may suggest that a child who has sustained a head injury needs a CT scan and possibly aggressive treatment.

"CT isn't bad if you really need it, but you don't want to use it in children who are at low risk for having a significant injury," said Nigrovic.

Each year in the U.S., there are about half a million emergency department visits for traumatic brain injury in children under 14 years of age. Boys age four and younger are most likely to be taken to the emergency department for a TBI-related emergency.

The Centers for Disease Control and Prevention has more on traumatic brain injury.

  • David W Freeman

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