Evaluation of infants undergoing cranial computed tomography in the emergency department due to head trauma

Pediatric head trauma is one of the most important public health issues worldwide and is one of the most common causes of morbidity and mortality in this age group. In infants, trauma of the same severity with adults bring different outcomes as the body structure is different compared to adults. Imaging methods are frequently used in infants presenting with trauma, since children in the 0-2 age group cannot express themselves, their neurological examination is limited and families of infants cannot provide clear information about trauma.  The best imaging method for trauma is cranial computed tomography (CCT). In this study, patients aged 0-2 years who applied to an emergency department of a training and research hospital in Istanbul between January 1, 2018 and January 31, 2018 were examined retrospectively. The aim of this study was to determine a clinical pathway by evaluating cranial computed tomography imagings of 0-2 year-old pediatric patients brought to the emergency department for head trauma. In our study, 523 patients aged 0-2 years were admitted for trauma between the specified time period and 166 of these patients underwent CCT. Of the patients who underwent CCT, 9% (n=15) were found to have pathology due to trauma. Ten of these patients underwent follow-up CCT.  One of 15 patients was found to have bone fracture. The other 14 patients were suspected of contusion. Of the patients who underwent CCT, 3.1% (n=5) were admitted to the ward for follow-up. When the patients were evaluated in terms of clinical course, hospitalization or discharge in our study, they were found to correlate with pathologies detected on CCT. Due to the intensity of the patients in the emergency department, sufficient time cannot be allocated for the examination and informing of patients. It was observed that Cranial CT request frequency increased especially between 16: 00-00: 00 hours when emergency department intensity increased. In infant trauma patients, imaging studies should be determined considering the severity and mechanism of trauma.