KIDS
May 20, 2011

Unnecessary CT Scans in Kids

Kids with minor injuries are exposed to excessive radiation from unnecessary CT scans. But are there risks with cutting back?

Though it may seem intuitive to make brain scans a routine part of treating a child’s head injury, a new study suggests that they may be unnecessary – and possibly detrimental – in some cases. Not only are most head injuries mild, but simple observation, rather than radiation, can often arrive at the same conclusion. Cutting down on the number of CT scans done on kids would also significantly reduce the amount of radiation to which they’re exposed.

Whether or not one CT scan could cause a meaningful increase in cancer risk, cutting down where possible certainly couldn’t hurt.

A study looked at some 40,000 cases of blunt head traumas in kids whose average age was about 5 ½ years. They compared a group of kids (5,400) who were observed for 4-6 hours before being scanned to a group of kids (numbering over 34,000) who were not observed before being scanned. They found that of the kids who were observed, 31% were ultimately scanned with CT. In the kids who were not observed, about 35% were scanned. The numbers of "clinically important brain trauma," defined as involving neurosurgery, intubation for an extended time, or death, were similar in both groups.

Though the difference may not sound like much, it is statistically significant, and suggests that a good number of kids could avoid unnecessary radiation by being observed first. The use of CT scans and the fear of radiation overdoses have been hotly debated in recent years. Whether or not one CT scan could cause a meaningful increase in cancer risk, cutting down where possible certainly couldn’t hurt.

The authors do point out that more studies will be needed to determine the optimum amount of time for observing children with head traumas. In many cases, it may seem easier to scan a child at the outset, to avoid the fear and anxiety a child (and his or her parents) surely experience during the observation period. Clearly a balance needs to be struck, between what’s best for the child (and parents) medically and psychologically.

The study was carried out by a team at Harvard Medical School and published in the May 9, 2011 online issue of the journal Pediatrics.

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