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Abstract
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BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries.
OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach.
METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma". All the studies including pediatric samples between 2000 and 2015 were considered for a critical revision while a minority of papers written before 2000 was analyzed because of their relevance.
RESULTS: The Pediatric Emergency Care Applied Research Network (PECARN) algorithm stratified the main risk factors for clinically relevant brain injuries (very low risk for children with normal mental status no loss of consciousness no vomiting, non-severe injury mechanism, no signs of basilar skull fracture, no severe headache, no evident clinical worsening over time and no multiple symptoms) and offered the only validated clinical prediction rule to select candidates for CT scans. Skull X-ray, cerebral magnetic resonance and cranial ultrasonography could provide useful information in selected cases.
CONCLUSIONS: The critical use of PECARN rule represents the best validated clinical tool for the early identification of children with a clinically relevant bran injury.
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Language: en |