head_injury_paed
Table of Contents
paediatric head injury
see also:
- Monash Concussion Clinic for children and adults - a low cost clinical psychology/neuropsychology service - an income tested sliding fee applies
- Serum glial fibrillary acidic protein levels are 97% accurate up to 7 days post injury of detecting brain injury such as concussion… may lead to a new biomarker that could reduce CT scans 1)
NICE 2014 indications for head CT scan within 1 hour
if ONE or MORE of
- suspicion of NAI
- post-traumatic seizure and no PH epilepsy
- GCS < 14 on arrival (<15 if < 1 yr old)
- GCS < 15 at 2hrs
- signs of base of skull #
- focal neurology
- suspected open # or depressed skull #
- tense fontanelle
- swelling / bruise / laceration > 5cm in those under 1 yr old
- on warfarin (scan can be delayed up to 8hrs??)
or MORE THAN ONE of
- witnessed LOC > 5 min
- abnormal drowsiness
- > 3 discrete vomiting episodes
- dangerous mechanism such as pedestrian, cyclist, vehicle occupant, fall > 3m, high speed injury from projectile or other object
- retrograde or anterograde amnesia > 5 min
references
1)
JAMA Neurology 2016. Brophy G, Welch R, Papa L, et al. Time Course and Diagnostic Accuracy of Glial and Neuronal Blood Biomarkers GFAP and UCH-L1 in a Large Cohort of Trauma Patients With and Without Mild Traumatic Brain Injury.
head_injury_paed.txt · Last modified: 2016/03/30 21:21 by 127.0.0.1