Background: Large studies which developed decision rules for the use of CT in children with minor head trauma excluded children with late presentation (more than 24 hours).
Objective: To assess the prevalence of significant traumatic brain injury (TBI) on CT in infants with head trauma presenting to the ED more than 24 hours from the injury.
Methods: A retrospective chart review of infants less than 24 months old referred for head CT because of traumatic brain injury (TBI) from January 2004 to December 2014 in Assaf-Harofeh medical center was conducted. We used the PERCAN definitions of TBI on CT to define significant CT findings.
Results: 344 cases were analyzed, 68 with late presentation.
There was no significant difference in the age between children with late and early presentation (11.44 ±5.63 month Vs 10.45±6.97 month, P=0.27). There was no significant difference between the groups in the incidence of significant TBI (22% Vs 19%, p=0.61). Any TBI on CT were found in 43 (63%) patients with late presentation compare with 116 (42%) patients with early presentation (p=0.002, OR 2.37, 95% CI 1.37 to 4.1).
Conclusion: There was no difference in the incidence of significant TBI between children presenting to the ED less than 24 hours after the injury and children with late presentation. Young children presenting to the ED more than 24 hours after the injury may have significant findings on CT.
