Faculty Collaboration Database

ACR Appropriateness Criteria® Head Trauma-Child. J Am Coll Radiol 2020 May;17(5S):S125-S137

Date

05/07/2020

Pubmed ID

32370957

DOI

10.1016/j.jacr.2020.01.026

Scopus ID

2-s2.0-85083692467 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

Head trauma is a frequent indication for cranial imaging in children. The majority of accidental pediatric head trauma is minor and sustained without intracranial injury. Well-validated pediatric-specific clinical decision guidelines should be used to identify very low-risk children who can safely forgo imaging. In those who require acute imaging, CT is considered the first-line imaging modality for suspected intracranial injury because of the short duration of the examination and its high sensitivity for acute hemorrhage. MRI can accurately detect traumatic complications, but often necessitates sedation in children, owing to the examination length and motion sensitivity, which limits rapid assessment. There is a paucity of literature regarding vascular injuries in pediatric blunt head trauma and imaging is typically guided by clinical suspicion. Advanced imaging techniques have the potential to identify changes that are not seen by standard imaging, but data are currently insufficient to support routine clinical use. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Author List

Expert Panel on Pediatric Imaging, Ryan ME, Pruthi S, Desai NK, Falcone RA Jr, Glenn OA, Joseph MM, Maheshwari M, Marin JR, Mazzola C, Milla SS, Mirsky DM, Myseros JS, Niogi SN, Partap S, Radhakrishnan R, Robertson RL, Soares BP, Udayasankar UK, Whitehead MT, Wright JN, Karmazyn B

Author

Mohit Maheshwari MD Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Contrast Media
Craniocerebral Trauma
Evidence-Based Medicine
Humans
Magnetic Resonance Imaging
Societies, Medical
United States