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Minor head trauma in infants and children: Management

Author
Sara Schutzman, MD
Section Editor
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

Head trauma occurs commonly in childhood. Most head trauma in children is minor and not associated with brain injury or long-term sequelae. However, a small number of children who appear to be at low risk may have a clinically important traumatic brain (ciTBI) injury.

The clinical challenge for evaluating minor head trauma in pediatric patients is to identify those infants and children with ciTBI while limiting unnecessary radiographic imaging and radiation exposure. Neuroimaging, usually with computed tomography (CT), is highly sensitive for identifying brain injury requiring acute intervention. However, individual clinical predictors for ciTBI are often nonspecific, particularly in young children. Thus, evaluation for high risk findings and the use of a clinical decision rule can provide a balanced approach that identifies almost all infants and children with ciTBI after minor head trauma without overuse of CT. Most infants and children with minor head trauma can be safely discharged home after careful evaluation without undergoing imaging. If neuroimaging is performed, those patients with normal clinical findings and imaging may also be discharged home.

The management of infants and children with mild head trauma is presented here.

The clinical features of head-injured children with and without brain injury and the evaluation of minor head trauma in children, concussion and mild head trauma in adolescents, severe traumatic brain injury (TBI) in children and adolescents, and abusive head trauma in children are reviewed separately:

(See "Minor head trauma in infants and children: Evaluation".)

                    

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Literature review current through: Nov 2016. | This topic last updated: Sat Jun 04 00:00:00 GMT+00:00 2016.
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