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  Study: Not every child needs a CT scan after head injury
October 7, 2009

For immediate release: October 7, 2009

Washington, DC—In the largest study of its kind, emergency physicians and researchers at Children’s National Medical Center working with the lead investigators at the University of California, Davis and several other leading pediatric research institutions have developed a set of data-driven, measurable criteria to help pediatric emergency physicians more effectively decide when to order a CT for a child with a head injury.

“Too often, children are unnecessarily exposed to radiation as a precautionary measure when presenting in the emergency department with mild head trauma,” said Shireen Atabaki, MD, a pediatric emergency physician at Children’s National and a co-author of the study. “This is the first time we’ve been able to collect a sample large enough to definitively draw conclusions about which symptoms carry high risk for brain injury in both older and pre-verbal children. This would allow a physician to avoid a CT on children that do not meet these high risk criteria and avoid unnecessary exposure to the radiation that accompanies the scan.”

The study was a multi-institutional collaboration as part of the Pediatric Emergency Care Applied Research Network (PECARN), led by a team at UC Davis and funded by the Health Resources and Services Administration at the U.S. Department of Health and Human Services. Based on a sample of more than 42,000 children with head trauma from 25 hospitals in the PECARN database, the study authors developed two separate sets of rules, one for children under the age of 2, and one for children over the age of 2, that outline a series of six symptoms and conditions that help doctors accurately identify children at higher risk of further complications from a head injury. The decision-making criteria include:
  • The way the child was injured
  • The child’s mental status at the time of evalaution
  • A history of loss of consciousness
  • Evidence of skull fracture
There are two additional factors that differ between the under 2 years and the 2 and older age groups.

Although these criteria in no way replace clinical judgment, they can help physicians supplement their clinical judgment and instincts with a set of evidence-based criteria for the first time.

Related links:

 Read the study, published online in The Lancet
 Read the media release from UC-Davis, lead authors of the research. 
 Learn more about the Division of Emergency Medicine and Trauma Services at Children’s National, which sees countless head injuries every year.
 Find out about the Pediatric Emergency Care Applied Research Network (PECARN) and Children’s role in the network.

Contact: Emily Dammeyer/ Jennifer Leischer: 202-476-4500.


About Children’s National Medical Center
Children's National Medical Center, located in Washington, DC, is a proven leader in the development of innovative new treatments for childhood illness and injury. Children’s has been serving the nation's children for more than 135 years. Children’s National is proudly ranked among the best pediatric hospitals in America by US News & World Report and the Leapfrog Group. For more information, visit Children’s Research Institute, the academic arm of Children’s National Medical Center, encompasses the translational, clinical, and community research efforts of the institution. Learn more about our research programs at