Version 1
: Received: 22 March 2024 / Approved: 24 March 2024 / Online: 25 March 2024 (13:13:56 CET)
How to cite:
Krüger, L.; Kamp, O.; Alfen, K.; Theyson, J.; Dudda, M.; Becker, L. Pediatric Carotid Injury after Blunt Trauma and the Necessity of CT and CTA – a Systematic Literature Review. Preprints2024, 2024031440. https://doi.org/10.20944/preprints202403.1440.v1
Krüger, L.; Kamp, O.; Alfen, K.; Theyson, J.; Dudda, M.; Becker, L. Pediatric Carotid Injury after Blunt Trauma and the Necessity of CT and CTA – a Systematic Literature Review. Preprints 2024, 2024031440. https://doi.org/10.20944/preprints202403.1440.v1
Krüger, L.; Kamp, O.; Alfen, K.; Theyson, J.; Dudda, M.; Becker, L. Pediatric Carotid Injury after Blunt Trauma and the Necessity of CT and CTA – a Systematic Literature Review. Preprints2024, 2024031440. https://doi.org/10.20944/preprints202403.1440.v1
APA Style
Krüger, L., Kamp, O., Alfen, K., Theyson, J., Dudda, M., & Becker, L. (2024). Pediatric Carotid Injury after Blunt Trauma and the Necessity of CT and CTA – a Systematic Literature Review. Preprints. https://doi.org/10.20944/preprints202403.1440.v1
Chicago/Turabian Style
Krüger, L., Marcel Dudda and Lars Becker. 2024 "Pediatric Carotid Injury after Blunt Trauma and the Necessity of CT and CTA – a Systematic Literature Review" Preprints. https://doi.org/10.20944/preprints202403.1440.v1
Abstract
Introduction
Blunt carotid injuries (BCI) in pediatric trauma are quite rare. Due to the low number of cases, only a few reports and studies have been conducted on this topic. This review will discuss how frequent BCI/ BCVI on pediatric patients after blunt trauma is, what routine diagnostics look like, if a CT/ CTA scan on pediatric patients after blunt trauma is always necessary and if there are any negative health effects?
Methods
This literature review includes reviews, systematic reviews, case reports and original studies in english language between 1999 and 2020 that have dealt with pediatric blunt trauma and the diagnostics of BCI and BCVI. Furthermore, publications on the risk of radiation exposure on children were included in the study. For literature research, Medline (PubMed) and the Cochrane library were used.
Results
Pediatric BCI/ BCVI, shows an overall incidence between 0.03 – 0.5% of confirmed BCI/ BCVI cases due to pediatric blunt trauma. 1.1 – 3.5% of pediatric blunt trauma patients underwent CTA to detect BCI. Only 0.17 – 1.2% of all CTA scans shows a positive diagnosis for BCI. In children, the median volume CT dose index on a non-contrast head CT is 33 milligray, a computed tomography angiography needs at least 138 mGy. A cumulative doses of about 50 mGy almost triples the risk of leukemia, and doses of about 60 mGy triples the risk of brain cancer.
Discussion
Knowing that a BCI could have extensive neurologic consequences for children, it is necessary to evaluate routine pediatric diagnostics after blunt trauma. Computed tomography scans (CT) and computed tomography angiography (CTA) are mostly used in routine BCI diagnostics. However, since radiation exposure in children should be as low as reasonably achievable, it should be asked if other diagnostic methods could be used to identify risk groups. Trauma guidelines and clinical scores like the McGovern score are reflect established BCI screening options, as well as using duplex ultrasound.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
