Diagnostic approach to children with minor traumatic brain injury.

ABSTRACT

STUDY PURPOSE: 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).