title: Minor head injury: limiting patient exposure to ionizing radiation, risk stratification, and concussion management.
abstract: OBJECTIVE
  We review recommendations from recent publications on the evaluation of minor head trauma. We focus on the risks of radiation from computed tomographies (CTs), the establishment of patient risk stratifications to help guide the necessity of emergent neuroimaging, and current thoughts regarding concussions.
  
  
  RESULTS
  Pediatric minor head injury is a common complaint in ambulatory settings. There is a significant amount of parental and practitioner anxiety regarding prognosis and whether or not to obtain CT imaging. New evidence has demonstrated the significant harmful effects of ionizing radiation. Recent studies have risk-stratified patients to identify those at risk of clinically important traumatic brain injury, to minimize the exposure to ionizing radiation for those who are at a low risk of any significant disorder.
  
  
  CONCLUSIONS
  Pediatric minor head injury is a common complaint, but the vast majority of those injured will suffer no significant consequences. The Pediatric Emergency Care Applied Research Network has created an algorithm to identify minor head trauma patients who require emergent head CTs versus those at low risk who do not require neuroimaging. Additionally, in recent years there has been an increase in the occurrence of concussions. We describe the characteristics of concussions, appropriate management, and the return-to-play guidelines.
authors.affiliation: aPediatrics Department bDivision of Pediatric Emergency Medicine, Cohen Children's Medical Center, New Hyde Park, New York, USA.
authors.forename: Shweta
authors.initials: S
authors.lastname: Bharadwaj
authors.forename: Joshua
authors.initials: J
authors.lastname: Rocker
mesh_terms: D000465:Algorithms; D001924:Brain Concussion / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000628:therapy; D002648:Child; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D018570:Risk Assessment / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000009:adverse effects