title: Clinical manifestations that predict abnormal brain computed tomography (CT) in children with minor head injury.
abstract: BACKGROUND
  Computed tomography (CT) used in pediatric pediatrics brain injury (TBI) to ascertain neurological manifestations. Nevertheless, this practice is associated with adverse effects. Reports in the literature suggest incidents of morbidity and mortality in children due to exposure to radiation. Hence, it is found imperative to search for a reliable alternative.
  
  
  OBJECTIVE
  The aim of this study is to find a reliable clinical alternative to detect an intracranial injury without resorting to the CT.
  
  
  METHODS
  Retrospective cross-sectional study was undertaken in patients (1-14 years) with blunt head injury and having a Glasgow Coma Scale (GCS) of 13-15 who had CT performed on them. Using statistical analysis, the correlation between clinical examination and positive CT manifestation is analyzed for different age-groups and various mechanisms of injury.
  
  
  RESULTS
  No statistically significant association between parameteres such as Loss of Consciousness, 'fall' as mechanism of injury, motor vehicle accidents (MVA), more than two discrete episodes of vomiting and the CT finding of intracranial injury could be noted. Analyzed data have led to believe that GCS of 13 at presentation is the only important clinical predictor of intracranial injury.
  
  
  CONCLUSIONS
  Retrospective data, small sample size and limited number of factors for assessing clinical manifestation might present constraints on the predictive rule that was derived from this review. Such limitations notwithstanding, the decision to determine which patients should undergo neuroimaging is encouraged to be based on clinical judgments. Further analysis with higher sample sizes may be required to authenticate and validate findings.
authors.affiliation: Department of Emergency Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Nesrin
authors.initials: N
authors.lastname: Alharthy
authors.affiliation: Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Sulaiman
authors.initials: S
authors.lastname: Al Queflie
authors.affiliation: Department of Medical Imaging, College of Medicine, King Abdulaziz Bin Saud University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Alyousef
authors.affiliation: College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Faisel
authors.initials: F
authors.lastname: Yunus
keywords: CATCH rule; Chi square test; Glasgow coma scale; contusion; hematoma