title: Is repeat head computed tomography necessary in children admitted with mild head injury and normal neurological exam?
abstract: BACKGROUND
  Children admitted following mild head injury (MHI) often undergo repeat head computed tomography (HCT) to identify progression of injury, although there is little evidence to support this practice.
  
  
  METHODS
  From January 2007 to December 2009, we retrospectively reviewed the medical records of patients aged 2 months to 18 years admitted with a diagnosis of MHI to a Level I Pediatric Trauma Center. Data including Glasgow Coma Scale, loss of consciousness, length of stay (LOS), and number and results of HCTs were analyzed.
  
  
  RESULTS
  A total of 507 patients were admitted with MHI and normal neurological exam; 389 had a normal and 118 had an abnormal initial HCT. The median LOS in the normal HCT group was 17.68 h (5.47-109.68) and in the abnormal HCT group 36.63 h (10.15-192.40). The median number of HCTs in the normal HCT group was 1 (1-2) and in the abnormal HCT group 2 (1-5).
  
  
  CONCLUSIONS
  Children admitted with MHI, abnormal initial HCT and normal neurological exam had longer LOS and more HCTs compared with children with normal initial HCTs. No patient in either group had any change in their management based on HCT. Therefore, repeat HCT may be unnecessary for patients with MHI and normal neurological exam.
authors.affiliation: Department of Pediatrics, University of Chicago, Chicago, IL 60637, USA. edawson@uchicago.edu
authors.forename: Emily C
authors.initials: EC
authors.lastname: Dawson
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Montgomery
authors.forename: David
authors.initials: D
authors.lastname: Frim
authors.forename: Tracy
authors.initials: T
authors.lastname: Koogler
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000639:trends*; D008297:Male; D010343:Patient Admission / Q000639:trends*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000639:trends*