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Clinical predictors of abnormal computed tomography scans in paediatric head injury


 Dr SM Ng, 83 Ashby, High Street, Drayton, Oxfordshire OX14 4JW, United Kingdom. Fax: +44 12 3553 0946; email:


Objective:  To evaluate whether clinical features associated with head injury in children can be correlated with an abnormal computed tomography (CT) scan.

Methodology:  Three hundred and eleven children aged 14 years or younger admitted with a diagnosis of acute head injury were studied retrospectively.

Results:  A Glasgow Coma Scale (GCS) score of 12 or lower and the presence of focal neurological deficits were significant predictors of an abnormal CT scan. Ninety-five per cent of those with abnormal CT scans and 100% of those with intracranial injury could be identified by the presence of one or more of the nine clinical findings, particularly by a GCS score of 12 or lower, and the presence of focal neurological deficits. Identification was also possible to a lesser degree by loss of consciousness, ataxia, amnesia, drowsiness, headache, seizure or vomiting.

Conclusion:  Use of CT scans can be limited to children with ongoing specific symptoms and/or focal neurological signs. The implementation of guidelines in the management of head injuries in children could have a substantial effect on clinical practice and health-care costs.