Braken als diagnosticum voor intracraniële complicaties in kinderen met licht schedelhersenletsel: een retrospectief onderzoek naar de afweging tussen het maken van een CT-scan en observatie.

Tilma, I. (Iris) (2014) Braken als diagnosticum voor intracraniële complicaties in kinderen met licht schedelhersenletsel: een retrospectief onderzoek naar de afweging tussen het maken van een CT-scan en observatie. thesis, Medicine.

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Abstract

Background. Approximately 12.000 children visit the emergency departments of Dutch hospitals annually with any form of traumatic brain injury. Although the occurrence of ICI is uncommon, the frequency of CT-scans increases quickly over the past few years. Routine use of CT-scan, however, has disadvantages. Within this research, vomiting will be reviewed as a possible diagnostic symptom for the presence of ICI in children with mild brain injury (LSHL). Material and methods. We conducted a retrospective study and enrolled children between 0-18 years with LSHL presenting at the Amalia child center in Zwolle between January 2011 and December 2013. We evaluated posttraumatic vomiting, drowsiness, headache, presence of raccoon eyes, behavioral change, insults and other symptoms like loss of consciousness, amnesia en neurologic abnormalities on the occurrence of ICI and performed tests of sensitivity, specificity, odds ratio and likelihood ratio in our statistical analysis using SPSS. Results. 403 children were enrolled. There was no significant association between any of the investigated symptoms (under which vomiting) and the occurrence of ICI (sens: 40, spec: 71, OR: 1.64 (0.27-9.95), LR: 2.07, P-value: 0.59). Only 1 child required surgical intervention in view of an epidural hematoma; because of a favorable presentation this child was initially send home without observation or medical imaging. Conclusion. There is no predictive value of one of the symptoms mentioned above for the presence of ICI in children presenting with LSHL. Bearing the low a priori risk on ICI in children with LSHL and the hazard of radiation in mind, an initial period of observation (watchful waiting) without medical imaging seems justified and safe.

Item Type:	Thesis (Thesis)
Supervisor name:	Brand, prof. dr. P.L.P.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:05
Last Modified:	25 Jun 2020 11:05
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2512

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