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Paediatric head injury — RACP Paediatrics MCQ

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HardEmergency paediatricsPaediatric head injuryRACP Paediatrics

A 6-year-old falls from a height of 2 metres. He vomits twice and has a brief loss of consciousness; in ED he is drowsy with GCS 13 and a large parietal scalp haematoma. What is the most appropriate investigation?

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Correct answer: A — Urgent CT brain

Reduced GCS after head injury with vomiting and significant mechanism warrants urgent CT brain to assess intracranial injury. Skull X-ray cannot exclude clinically important brain injury. Observation may be appropriate for lower-risk children, but drowsiness and GCS 13 are high-risk features.

Reference: RCH Head injury guideline; Australian paediatric trauma guidance