{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:40:02Z","timestamp":1746384002807,"version":"3.40.4"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Children with hemophilia have the usual childhood risk of falls and head trauma. Head computed tomographies (HCTs) are fast, detailed, and readily available, but increased radiation exposure in the pediatric population is now recognized as causing increased brain malignancy. By examining the incidence of intracranial cerebral hemorrhage in this population, we will be able to weigh risks and benefits of HCT use more accurately.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Using a retrospective chart review, we examined past medical records of pediatric patients, aged 0 to 15 years, with hemophilia presenting to 1 academic medical center. Primary outcomes included number of head CTs ordered, total and per patient over the years studied, and the incidence of positive findings, as defined by presence of blood products as documented by radiologist final read\/interpretation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The mean number of head CTs per child was 2.5 (range, 1\u201310). None of the HCT scans were read as intracranial cerebral hemorrhage, and none of the patients had findings that lead to neurosurgical intervention. In a sensitivity analysis, applying Pediatric Emergency Care Applied Research Network head injury criteria, 11 HCT scans would be ordered for a reduction of 80 HCTs, or a decrease of 2 HCT scans per child. No incidence of intracranial cerebral hemorrhage would have been missed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Our findings suggest that in the child with hemophilia and a history of minor head trauma, exposure to the radiation of a HCT based on the diagnosis of hemophilia alone may not be necessary but that imaging decisions need to be made in conjunction with clinical examination findings and neurologic status.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002595","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T19:25:24Z","timestamp":1640287524000},"page":"e27-e28","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Computed Tomography Scans in Children With Hemophilia After Minor Head Trauma"],"prefix":"10.1097","volume":"38","author":[{"given":"Alison","family":"Gardner","sequence":"first","affiliation":[{"name":"Pediatrics and Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas W.","family":"McLean","sequence":"additional","affiliation":[{"name":"Pediatrics Hematology\/Oncology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"Winslow","sequence":"additional","affiliation":[{"name":"Emergency Medicine, Wake Forest Baptist Health, Winston-Salem, NC."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,12,23]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2214\/ajr.176.2.1760289","article-title":"Estimated risks of radiation-induced fatal cancer from pediatric CT","volume":"176","year":"2001","journal-title":"AJR Am J Roentgenol"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1001\/jamapediatrics.2013.311","article-title":"The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk","volume":"167","year":"2013","journal-title":"JAMA Pediatr"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/S0140-6736(09)61558-0","article-title":"Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study","volume":"374","year":"2009","journal-title":"Lancet"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1111\/j.1365-2516.2007.01545.x","article-title":"Intracranial bleeding in haemophilia beyond the neonatal period\u2014the role of CT imaging in suspected intracranial bleeding","volume":"13","year":"2007","journal-title":"Haemophilia"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1046\/j.1365-2516.2003.00789.x","article-title":"Intracranial haemorrhage among a population of haemophilic patients in Brazil","volume":"9","year":"2003","journal-title":"Haemophilia"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1182\/blood.V51.6.1179.1179","article-title":"Central nervous system bleeding in hemophiliacs","volume":"51","year":"1978","journal-title":"Blood"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1046\/j.1365-2516.1999.00338.x","article-title":"Prevalence and incidence of intracranial haemorrhage in a population of children with haemophilia. The Hemophilia Growth and Development Study","volume":"5","year":"1999","journal-title":"Haemophilia"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1002\/pbc.22126","article-title":"The clinical management of hemophilia and head trauma: a survey of current clinical practice among pediatric hematology\/oncology physicians","volume":"53","year":"2009","journal-title":"Pediatr Blood Cancer"},{"key":"bib9-20250504","first-page":"1045","article-title":"Clinical predictors of severe head trauma in children","volume":"142","year":"1988","journal-title":"Am J Dis Child"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/0022-3468(94)90517-7","article-title":"Head trauma in children with congenital coagulation disorders","volume":"29","year":"1994","journal-title":"J Pediatr Surg"},{"key":"bib11-20250504","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1136\/bmj.328.7430.19","article-title":"Effect of low doses of ionising radiation in infancy on cognitive function in adulthood: Swedish population based cohort study","volume":"328","year":"2004","journal-title":"BMJ"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002595","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:12:09Z","timestamp":1746382329000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,23]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002595","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"type":"electronic","value":"1535-1815"},{"type":"print","value":"0749-5161"}],"subject":[],"published":{"date-parts":[[2021,12,23]]}}}