Mild traumatic brain injury in infants and children. Diagnostic and treatment strategies

Traumatic brain injury (TBI) is one of the most common injuries in childhood but the assessment of mild TBI regarding further management varies significantly. Vomiting is a major symptom, which shows good correlation with the severity of traumatic brain injury. The neurological examination and assessment of the course are important in the follow-up of these children and ultrasound is the major diagnostic imaging method in infants. The indications for cranial computed tomography (CT) must be strictly limited because of the high radiation exposure but a CT scan is indicated in cases of coma, persistent disturbance of consciousness, focal neurological deficits or suspected compression fracture. A CT scan in a vital, adequately responsive child without focal neurological symptoms has no therapeutic consequences and is therefore not indicated. If headaches persist magnetic resonance imaging (MRI) should be initiated.