Emergency and critical care medicine: Edited by Jean KligMinor head injury in childrenKlig, Jean Ea; Kaplan, Carl PbAuthor Information aPediatric Emergency Department, Massachusetts General Hospital for Children, Harvard Medical School, Zero Emerson Place, Boston, Massachusetts, USA bPediatric Emergency Department, Stony Brook University Hospital, Stony Brook University School of Medicine, New York, USA Correspondence to Carl P. Kaplan, MD, Pediatric Emergency Department, Stony Brook University Hospital, Stony Brook University School of Medicine, HSC Level 4, Room 080 Stony Brook, NY 11794, USA E-mail: email@example.com Current Opinion in Pediatrics: June 2010 - Volume 22 - Issue 3 - p 257-261 doi: 10.1097/MOP.0b013e328339736e Buy Metrics Abstract Purpose of review This review will examine mild closed head injury (CHI) and the current evidence on head computed tomography (CT) imaging risks in children, prediction rules to guide decisions on CT scan use, and issues of concussion after initial evaluation. Recent findings The current literature offers preliminary evidence on the risks of radiation exposure from CT scans in children. A recent study introduces a validated prediction rule for use in mild CHI, to limit the number of CT scans performed. Concurrent with this progress, fast (or short sequence) MRI represents an emerging technology that may prove to be a viable alternative to CT scan use in certain cases of mild CHI where imaging is desired. The initial emergency department evaluation for mild CHI is the start point for a sequence of follow-up to assure that postconcussive symptoms fully resolve. The literature on sports-related concussion offers some information that may be used for patients with non-sports-related concussion. Summary It is clear that CT scan use should be as safe and limited in scope as possible for children. Common decisions on the use of CT imaging for mild head injury can now be guided by a prediction rule for clinically important traumatic brain injury. Parameters for the follow-up care of patients with mild CHI after emergency department discharge are needed in the future to assure that postconcussive symptoms are adequately screened for full resolution. © 2010 Lippincott Williams & Wilkins, Inc.