Some doctors are too quick to send a child with a head injury to get a CT scan, according to the results of two studies presented at the Pediatric Academic Societies annual meeting. Head CT scans are used to look for brain bleeds and other signs of serious head injury in children who have experienced a blow to the head or other head trauma. Unfortunately, CT scans are also a significant source of radiation – and in some childhood head injury cases, they aren’t needed.
A Head CT Scan Isn’t Always Necessary for a Child with a Head Injury
According to this study, doctors may be better off observing a child with a head injury closely rather than sending them directly to be scanned. Rebecca Kriss, M.D., a pediatrician at Inova Fairfax Hospital for Children said that, “a significant number of children receiving CT scans don’t appear to have clinical justification for the procedure”. After looking at records of 394 children under the age of five who had a head CT scan for childhood head trauma, four out of ten children lacked clear indicators that a head CT scan was needed. Of the head CT scans that were performed, only 38% were abnormal.
Using head CT scans for childhood head injury may be necessary to make sure a more serious head injury such as a bleeding blood vessel in the brain, a fractured skull, or swelling of the brain tissues hasn’t occurred – but which children need a head CT scan can usually be determined by doing a careful neurological exam looking for “red flag” signs of a more serious head injury. If a child has none of these signs, it may be safe to observe them before doing a scan. In some cases of childhood head trauma, a child is sent directly to be scanned without being evaluated by the doctor first.
Head CT Scans and Radiation
Why the concern about giving a child with a head injury a head CT scan? Shockingly, some CT scans expose a child to the radiation equivalent of 500 chest x-rays. Children are more sensitive to the effects of radiation from x-rays and CT scans because their cells are dividing more rapidly, putting them at greater risk for cancer causing mutations. The risk is greatest in children under the age of ten.
Childhood Head Trauma and Head CT Scans: The Bottom Line
Sometimes a head CT scan is needed in the case of childhood head trauma, but a child should be examined by a doctor before a head CT scan is ordered except in cases of severe head trauma. The doctor should also explain why the scan is needed – based on the results of the physical exam.
If a child with a head injury does need a head CT scan, adjustments can be made to lower the dose of radiation – although many techs don’t automatically make these adjustments. Talk to the radiology technician beforehand and make sure your child gets the lowest amount of radiation possible.