{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:02:13Z","timestamp":1791644533583,"version":"4.3.4"},"reference-count":40,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science, Technological Development and Innovation of the Republic of Serbia","award":["200110"],"award-info":[{"award-number":["200110"]}]},{"name":"Ministry of Science, Technological Development and Innovation of the Republic of Serbia","award":["01-3-36"],"award-info":[{"award-number":["01-3-36"]}]},{"name":"University of East Sarajevo, Faculty of Medicine Foca, RS, BiH","award":["200110"],"award-info":[{"award-number":["200110"]}]},{"name":"University of East Sarajevo, Faculty of Medicine Foca, RS, BiH","award":["01-3-36"],"award-info":[{"award-number":["01-3-36"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Mild traumatic brain injury (mTBI) is a leading cause of pediatric emergency department visits, particularly among children under three years old. Although computed tomography (CT) is the gold standard for diagnosing intracranial injuries, its use in young children poses radiation risks. Identifying reliable clinical indicators that justify CT imaging is essential for optimizing both patient safety and resource utilization. Objective: This study aimed to evaluate CT findings in children under three years of age with mTBI and no focal neurological deficits, as well as to identify clinical predictors associated with skull fractures and intracranial injuries. Methods: A retrospective analysis was conducted on 224 children under 36 months who presented with mTBI to a tertiary pediatric hospital from July 2019 to July 2024. Demographic data, injury mechanisms, clinical presentation and CT findings were evaluated. Univariate and multivariate regression analyses were performed to identify risk factors associated with skull fractures and intracranial injuries. Results: Falls accounted for 96.4% of injuries, with the majority occurring from heights of 0.5\u20131 m. The parietal region was the most frequently affected site (38%). Skull fractures were present in 46% of cases and were primarily linear (92.8%). Intracranial hematomas were identified in 13.8% of cases, while brain edema was observed in 7.6%. Significant predictors of skull fractures included age under 12 months (p &lt; 0.001), falls from 0.5\u20131 m (p = 0.005), somnolence (p = 0.030), scalp swelling (p = 0.001) and indentation of the scalp (p = 0.016). Parietal bone involvement was the strongest predictor of both skull fractures (OR = 7.116, p &lt; 0.001) and intracranial hematomas (OR = 4.993, p &lt; 0.001). Conversely, frontal bone involvement was associated with a lower likelihood of fractures and hematomas. Conclusions: The findings highlight key clinical indicators that can guide decision-making for CT imaging in children with mTBI. Infants under 12 months, falls from moderate heights and parietal bone involvement significantly increase the risk of fractures and intracranial injuries. A more refined diagnostic approach could help reduce unnecessary CT scans while ensuring the timely identification of clinically significant injuries.<\/jats:p>","DOI":"10.3390\/jcm14082728","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T04:05:31Z","timestamp":1744776331000},"page":"2728","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Computed Tomography Findings of Children Under 3 Years of Age with Mild Traumatic Brain Injury (TBI) and No Neurological Focal Signs"],"prefix":"10.3390","volume":"14","author":[{"given":"Ksenija","family":"Markovic","sequence":"first","affiliation":[{"name":"Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8066-5701","authenticated-orcid":false,"given":"Goran","family":"Djuricic","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, University Children\u2019s Hospital, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djordje","family":"Milojkovic","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, University Children\u2019s Hospital, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1014-5337","authenticated-orcid":false,"given":"Dusan","family":"Banovac","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, University Children\u2019s Hospital, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3362-5042","authenticated-orcid":false,"given":"Kristina","family":"Davidovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8005-046X","authenticated-orcid":false,"given":"Dragan","family":"Vasin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Sisevic","sequence":"additional","affiliation":[{"name":"Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0010-0971","authenticated-orcid":false,"given":"Slavisa","family":"Zagorac","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9433-1446","authenticated-orcid":false,"given":"Boris","family":"Gluscevic","sequence":"additional","affiliation":[{"name":"Institute for Orthopedic Surgery \u201cBanjica\u201d, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejan","family":"Bokonjic","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Foca, University of East Sarajevo, 71123 Foca, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vuk","family":"Djulejic","sequence":"additional","affiliation":[{"name":"Laboratory for Multimodal Neuroimaging, Institute of Anatomy, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasa","family":"Milic","sequence":"additional","affiliation":[{"name":"Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jsr.2019.12.013","article-title":"Traumatic brain injury mortality among U.S. children and adolescents ages 0-19 years, 1999-2017","volume":"72","author":"Cheng","year":"2020","journal-title":"J. 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