小児頭部外傷における 放射線検査適応についての検討：簡単な症状・所見より判断可能か？

抄録

Background: The indication of radiological examination for head injury in children often discussed. The aim of this study was to identify clinical factors related to abnormal findings on radiological examination.

Methods: We enrolled 565 patients younger than 15 years, who underwent radiological examination for head injury between January 2009 and December 2010. We collect data on 3 parameters: age, subjective symptoms such as nausea, vomiting and headache, and scalp hematoma.

Results: There were no significant differences in abnormal findings on radiological examination between patients aged 0–2 and 3–15 years old, and between those with and without subjective symptoms. Seven of 276 patients without scalp hematoma, 14 of 225 with small scalp hematoma (< 3 cm), and 17 of 26 with large scalp hematoma (> 3 cm) showed ab­normal findings. There was a significant difference between the three groups (p<0.0001).

Conclusion: Scalp hematoma, especially that more than 3 cm, should be considered as an indication for radiological examination in children with head injury.