Please note: Choosing Wisely is a national campaign, spearheaded by the American Board of Internal Medicine Foundation, that seeks to help patients and doctors find ways to improve patient safety and reduce wasteful health care spending. At Independent Health, we are committed to working with our physician partners and members on opportunities to improve the quality and affordability of care. As part of this effort, Independent Health will be providing a series of articles to help “HEALTHStyles Monthly” readers choose wisely when it comes to certain medical tests and treatments. This is the eighth article in the series.
A blow to the head can be scary, especially when your child suffers one. But, usually, it is not very serious. Often, there is just a mild concussion, with no serious injuries, like bleeding or cracks to the skull.
After a head injury, the doctor may order a test called a CT scan. A CT scan takes many X-rays to create a 3-D picture of the brain. But your child may not need a scan for a minor head injury. Here’s why:
CT scans are often unnecessary
About half of children in emergency rooms with head injuries get CT scans. But one in three of these scans aren’t necessary. Before ordering a scan, the doctor should examine the child and ask about the injury and symptoms. If your doctor thinks your child has a mild concussion, a CT scan will probably not be helpful—the scan results are usually normal. CT scans are better for other kinds of injuries, such as skull fractures or bleeding in the brain. A concussion is not caused by bleeding in the brain.
CT scans have risks
CT scans use radiation, which can increase the risk of cancer. Children, and especially infants, have greater risks because their brains are still developing. And unnecessary CT scans can lead to more tests and treatments, with more risks.
CT scans are expensive
CT scans of the brain can cost between $500 and $900. Costs vary widely. It’s OK to ask whether the scan is really needed before spending the money.
When to see a doctor
Go to the doctor right away if your child becomes unconscious, has a headache that won’t stop, or is dizzy, confused, or nauseous. These symptoms may happen hours or days later.
When to get a CT scan of the brain
A doctor should order a CT scan if it is likely that the child has a skull fracture or bleeding. The doctor should ask about the accident and any symptoms your child may be experiencing. This may include dizziness or losing balance, becoming unconscious, tingling on one side of the body, being very sleepy or irritable, and/or having a headache that gets worse. The doctor should also examine the child for signs of skull fracture, such as black eyes and bleeding.
What to expect if a CT scan is needed
- The CT scan should happen soon. The child may need immediate treatment.
- The doctor will use the lowest dose of radiation.
- The scan will include only the head (unless there may be a neck or spine injury).
- Repeated scans will be avoided.
This article is not a substitute for medical advice and treatment. If you have questions about CT scans, please speak with your doctor. To learn about the “5 key questions” you can ask to ensure you are Choosing Wisely as a patient, click here.
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