Brain damage in children and CT scans - September 15, 2009

A study dealing with the identification of children at very low risk of clinically-important brain injury after trauma to the head, was recently published by The Early Online Publication of The Lancet Medical Journal.

Because CT imaging of head-injured children carries the risk of radiation-induced malignancy, the purpose of the study was to identify children at a very low risk of traumatic brain injury for whom imaging may be unnecessary. The use of CT scans has doubled from 1995 to 2005 and a 2001 study estimated that roughly one child in 1,100 who received a CT scan may ultimately die from cancer caused by the radiation.

The study is described as the most extensive study concerning head injuries in children and CT scans to date. Data was analyzed from more than 42,000 children under 18 with apparently minor head trauma in 25 hospitals across the country.

The study found that 20 percent of children over the age of 2 with minor head trauma were at such a low risk of serious brain damage that CT scanning was unnecessary.  The number was 25 percent when head trauma in infants under the age of 2 was studied.

The lead author Dr. Nathan Kupperman, from the University of California, Davis, concluded that for such children, the minuscule chance of catching a serious brain injury is outweighed by the dangers of exposing these children to radiation.

"It looks like CT scans are being overused," Dr. Kupperman said. "While cost was not the motivating factor in our study, it seems that CT scans are being used inefficiently."