Isolated Headache after Bump Poses Little Brain Injury Risk for Kids

If a headache is a kid's only symptom after minor blunt head trauma, it poses little risk of a clinically important brain injury, according to a new post-hoc analysis 

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By Reuters Staff

NEW YORK (Reuters Health) - If a headache is a kid's only symptom after minor blunt head trauma, it poses little risk of a clinically important brain injury, according to a new post-hoc analysis published online February 2 in Pediatrics.

"This strongly suggests that (computed tomography scans) CTs are not indicated in most children with headaches and no other signs or symptoms of (traumatic brain injury) after blunt head trauma, and a period of observation may be warranted before CT decision-making," Dr. Peter Dayan, who led the study at New York Presbyterian Morgan Stanley Children's Hospital in New York, and his colleagues wrote.


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The researchers examined data from a prospective observational study, focusing on kids admitted for minor blunt head trauma, which they defined as a Glasgow Coma Scale score of 14 or 15 on the 15-point scale.

Not one of nearly 2500 kids evaluated had a clinically important brain injury when their only symptom was a headache. Commuted tomography scans found traumatic brain injury in three out of 456 kids with isolated headaches, representing 0.7% of patients.

In comparison, 1.6% of the kids in a group of more than 10,000 who had headaches and other symptoms had clinically important brain injuries, the researchers found. Likewise the researchers calculated a 1.6% difference in risk between kids with isolated headaches and those with headaches plus other symptoms.

Dr. Dayan was not available for comment.

This research was supported by the Health Resources and Services Administration Maternal and Child Health Bureau, Division of Research, Education, and Training, and the Emergency Medical Services of Children program. The authors report no disclosures.

SOURCE: http://bit.ly/1z9Juv0

Pediatrics 2015.

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