Why Your Child Should Not Get A CAT Scan After A Head Injury September 17, 2009

Naturally, we worry greatly when our children suffer head injuries. All manner of worst case scenario thoughts race through our heads. However, new developments in medicine indicate that our concern, both personally and as a society, for our children is doing them more harm than good.

A new study found that 20-25 percent of American children who suffer head injuries receive unnecessary CAT scans. For children with non-severe head injuries who receive a CAT scan, the risk that they will develop brain cancer from the CAT scan radiation exposure is greater than their risk of serious brain trauma.

Cancer is now the most common disease cause of death in children under the age of 10. Although brain cancer itself is relatively uncommon, brain cancer and leukemia are the most prevalent forms of cancer in children under 10. Therefore, radiation exposure to the brain of developing children is of particular concern.

The study examined 42,000 cases of child head injuries. With such a large sample size, scientists say the study’s results are considered very solid. This is important because CAT scan overuse for child head injuries has been suspected for years, but no study until now has been sufficiently conducted or large enough to be considered accurate.

Researchers found that of all cases studied, that only 1 percent (376) were considered serious traumatic brain injuries, and that only 60 of those required brain surgery. The U.S. Centers for Disease Control reports that about 435,000 children are examined for traumatic brain injury. Not all children who suffer head injuries develop traumatic brain injuries. Many are “mild” injuries characterized by only a brief loss of consciousness, if any. These non-serious injuries are the type that do not require CAT scans.

To help determine which children with head injuries should receive a CAT scan and which should not, researchers created guidelines for medical providers and doctors to follow. One set of guidelines exists for children younger than 2 and another for children 2 and older. Those younger than 2 cannot communicate as well as older children so we must look for different signs in them. In addition, younger children are more sensitive to radiation.

Children younger than 2 should not receive CAT scans following head injuries if they exhibit a normal mental status, normal behavior, and have no swelling except for the front of their head, have not lost consciousness for more than five seconds, have no noticeable skull fracture and were injured in a non-severe way.

The signs are similar for children 2 and older. However, they can report the presence of a headache. If no headache is reported and all the signs for younger children check out, a child with a head injury who is 2 or older should not receive a CAT scan.