The risk of clinically significant intracranial injury in these patients is estimated at approximately 4.4% [5]. Although still relatively uncommon, the risk of interveneable injury is substantial enough that imaging is strongly recommended. CT has the advantage of rapid acquisition and excellent sensitivity for acute intracranial hemorrhage and fractures. CTA Head Most vascular injuries in children are cervical, and there remains a relative paucity of evidence-based literature regarding the prevalence and nature of isolated intracranial vascular injury in pediatric head trauma. Intracranial vascular injuries have been reported in children with minor head trauma but are likely uncommon [19,34,35]. Vascular imaging is usually not a standard component of initial first-line imaging evaluation in patients with minor head trauma. However, if there are clinical symptoms or signs on other imaging raising suspicion for vascular injury, such as basilar fracture through a vascular canal, CTA may be considered for rapid assessment in the acute setting. MRI Head MRI is sensitive for acute intracranial hemorrhage and other intracranial traumatic injuries. However, MRI in the emergent setting is frequently impractical. The examination is typically significantly longer than CT, requires safety screening, results take longer to obtain, and younger children often need sedation to complete the examination, further delaying assessment. IV contrast is typically of little use in evaluation of acute trauma. MRA Head There remains a relative paucity of evidence-based literature regarding the prevalence and nature of vascular injury in minor pediatric head trauma. Vascular injuries have been reported in children with minor head trauma but are likely uncommon [19,34,35]. Vascular imaging is generally not a standard component of initial first-line imaging evaluation in patients with minor head trauma. If there are clinical or other imaging signs suggestive of vascular injury, MRA could be considered.
Head Trauma Child PCAs. The risk of clinically significant intracranial injury in these patients is estimated at approximately 4.4% [5]. Although still relatively uncommon, the risk of interveneable injury is substantial enough that imaging is strongly recommended. CT has the advantage of rapid acquisition and excellent sensitivity for acute intracranial hemorrhage and fractures. CTA Head Most vascular injuries in children are cervical, and there remains a relative paucity of evidence-based literature regarding the prevalence and nature of isolated intracranial vascular injury in pediatric head trauma. Intracranial vascular injuries have been reported in children with minor head trauma but are likely uncommon [19,34,35]. Vascular imaging is usually not a standard component of initial first-line imaging evaluation in patients with minor head trauma. However, if there are clinical symptoms or signs on other imaging raising suspicion for vascular injury, such as basilar fracture through a vascular canal, CTA may be considered for rapid assessment in the acute setting. MRI Head MRI is sensitive for acute intracranial hemorrhage and other intracranial traumatic injuries. However, MRI in the emergent setting is frequently impractical. The examination is typically significantly longer than CT, requires safety screening, results take longer to obtain, and younger children often need sedation to complete the examination, further delaying assessment. IV contrast is typically of little use in evaluation of acute trauma. MRA Head There remains a relative paucity of evidence-based literature regarding the prevalence and nature of vascular injury in minor pediatric head trauma. Vascular injuries have been reported in children with minor head trauma but are likely uncommon [19,34,35]. Vascular imaging is generally not a standard component of initial first-line imaging evaluation in patients with minor head trauma. If there are clinical or other imaging signs suggestive of vascular injury, MRA could be considered.