Diagnostic approach to children with minor traumatic brain injury.
OBJECTIVE
To analyse the management of minor traumatic brain injury (MTBI) in paediatric hospitals in Germany.


METHODS
An electronic survey was sent to 72 children hospitals.


RESULTS
All participating (45/72; 62.5 %) hospitals had facilities to perform an electroencephalogram (EEG), 98 % cranial ultrasonography, 94 % MRI studies, and 87 % a CT scan. The initial Glasgow Coma Scale, the clinical presentation/neurological deficits, the intensity of the trauma and external/visible injuries were most important for initial assessment. The main reason for in-patient monitoring was initial clinical neurologic presentation (44 %). X-ray scans were used routinely in only 2.2 %, cMRI scans in 6.7 % and cCT scans in 13.3 %; approximately one third employed ultrasonography. In 22.2 % was an EEG part of the routine diagnostic work-up. Inpatient monitoring for 24-48 h was done in 80 %.


CONCLUSIONS
Children with MTBI are often monitored clinically without resorting to potentially harmful and expensive diagnostic procedures (cCT scans).
Section Neuropediatrics, University Children's Hospital of Saarland, Homburg, Germany.
Isabel
I
Oster
Ghiath M
GM
Shamdeen
Karin
K
Ziegler
Regina
R
Eymann
Ludwig
L
Gortner
Sascha
S
Meyer
D000293:Adolescent; D000465:Algorithms; D001924:Brain Concussion / Q000175:diagnosis / Q000628:therapy; D001930:Brain Injuries / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D004453:Echoencephalography / Q000706:statistics & numerical data; D004569:Electroencephalography / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data*; D016489:Head Injuries, Closed / Q000175:diagnosis* / Q000628:therapy*; D006302:Health Services Research; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data; D009460:Neurologic Examination / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D011379:Prognosis; D012815:Signal Processing, Computer-Assisted; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014600:Utilization Review / Q000706:statistics & numerical data