 Introduction/Background Head trauma is a common indication for cranial imaging in children. Although traumatic brain injury is a leading cause of death and disability in children [1], the vast majority of head injuries are uncomplicated, transient, and do not require intervention [2]. The necessity of identifying clinically relevant, potentially treatable injury must be weighed against the risks of performing unwarranted imaging studies, possible unnecessary sedation, and inappropriate resource utilization. The precise criteria for minor head injury are not consistent in the literature, but this usually refers to a patient with normal or near-normal postevent mental status and is often defined by a Glasgow Coma Scale (GCS) of 14 or 15 [3]. The probability of significant anatomic injury in minor head trauma is low. Approximately 3% to 5% of children with minor head trauma have identifiable abnormalities by imaging but typically less than 1% requires neurosurgical intervention [4-7]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Head Trauma-Child injury but resulted in a relatively high rate of CTs [13]. Additional smaller validation trials in the United States and abroad have also determined the PECARN criteria for very low risk criteria to be 100% sensitive [14-17].
Head Trauma Child PCAs.  Introduction/Background Head trauma is a common indication for cranial imaging in children. Although traumatic brain injury is a leading cause of death and disability in children [1], the vast majority of head injuries are uncomplicated, transient, and do not require intervention [2]. The necessity of identifying clinically relevant, potentially treatable injury must be weighed against the risks of performing unwarranted imaging studies, possible unnecessary sedation, and inappropriate resource utilization. The precise criteria for minor head injury are not consistent in the literature, but this usually refers to a patient with normal or near-normal postevent mental status and is often defined by a Glasgow Coma Scale (GCS) of 14 or 15 [3]. The probability of significant anatomic injury in minor head trauma is low. Approximately 3% to 5% of children with minor head trauma have identifiable abnormalities by imaging but typically less than 1% requires neurosurgical intervention [4-7]. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Head Trauma-Child injury but resulted in a relatively high rate of CTs [13]. Additional smaller validation trials in the United States and abroad have also determined the PECARN criteria for very low risk criteria to be 100% sensitive [14-17].