Stories about: brain injury

Are CT scans being overused in monitoring head injury?

High tech imaging is the gold standard for identifying brain injury. But is it always necessary?

Seems like everywhere you turn, there’s new information about how dangerous head injuries can be. And because they can be so devastating, many doctors are quick to use computed tomography (CT) scans to check for serious injury when they see a young patient who has suffered a blow to the head. (Almost 50 percent of all children taken to U.S. emergency departments for head injury have a CT performed.) But according to a new study co-lead by Lise Nigrovic, MD, MPH, at Children’s Hospital Boston, these CT scans are used far more often than they need to be.

“Only a small percentage of children with blunt head trauma really have something serious going on,” she says. “If a child has suffered a serious injury and is at high risk for head trauma he needs to receive a CT right away. But if the child is at an intermediate risk he can be watched in the ED for a few hours and may not need a CT at all.”

To produce their images, CT scanners use small doses of ionized radiation. The patient’s level of exposure to that radiation is extremely low, but there is data indicating that even small exposure can lead to increased life time risk of cancer. Children may be especially susceptible to this exposure, because their developing tissue is particularly sensitive to the affects of radiation. (Read about the ways Children’s Hospital Boston ensures safety of its patients who receive specialized imaging.)

Based on this information, clinicians are left with a difficult question: How severe must a head trauma be for the benefits of a CT scan to outweigh the risk associated with its use?

Lise Nigrovic, MD, MPH

“Probably less than one percent of the kids who come to emergency departments for head injury have serious enough head trauma to warrant a CT,” Nigrovic says. “But clinicians have the difficult challenge of figuring which patients do fall into that one percent. It’s not quite a needle in the haystack scenario, but it can be difficult.”

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Health headlines: Unhealthy cholesterol, parents grade schools and the First Lady’s war on childhood obesity

Other stories we’ve been reading:

We discovered this week that Thrive is listed as one of the top 50 early childhood health blogs! school gradeThe FDA voices some concern over BPA risk. Using the term “concussion” versus “brain injury” garners different responses from parents.

Parents feel traumatic stress after their child’s been injured. Twenty percent of teens have unhealthy cholesterol. Researchers are asking why U.S. birth rates are falling.

Parents get to grade public schools. Children raised by same-sex couples do just as well as those raised by parents of both sexes. First Lady, Michelle Obama is launching a major initiative to fight childhood obesity.

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Careful not to slip-slide your way into a winter sports injury

Lois Lee, MD, MPH works in Children’s Emergency Department Injury Prevention Program

Having grown up in Florida, I never The boy laying on snowunderstood the appeal of winter sports until my son took up skiing. Now, to keep him and his sister active in the winter, we enjoy skiing, sledding and ice skating. These are great family activities, but they do carry some risk. Read on for safety tips to keep healthy while having fun in the cold!

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Concussions: heads, you lose

sports_concussionMany athletes think they’ll never make it to the big league unless they’re willing to play hard and take a few knocks on the  field. But does playing hard mean that they should play hurt—especially if they’ve had a blow to the head?

At every level of competitive sports, coaches, athletes and parents are rethinking when it’s appropriate for athletes return to the game. As Children’s Hospital Boston’s William Meehan, MD, director of the Sports Concussion Clinic in the Division of Sports Medicine, writes in an article for The MetroWest Daily News, the days of an athlete having his bell rung and then jumping back int to the game are  gone. Read his story here and tell us what you think.

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