CT should not be relied on for cases of isolated vomiting in children with blunt head trauma.

Context Accurate emergency diagnostic work up of children who have sustained a minor traumatic brain injury (TBI) is challenging. In most cases, symptoms are non-specific and may include episodes of altered or transient loss of consciousness, irritability, sleepiness or headache. Each physician must decide if clinical observation is sufficient to exclude intracranial complications or if a more aggressive diagnostic approach, including neuroimaging (eg, CT) should be pursued. The growing awareness of radiation-induced side effects urges each physician to take full advantage of the clinical findings. The current paper suggests that a history of vomiting is linked to an increased prevalence of TBI seen on CT, while the absence of vomiting is coupled with a decreased prevalence of TBI on CT. The desire to have an easy, safe, practical and reproducible diagnostic sign to predict TBI may have pushed for the inclusion of ‘vomiting’ in the diagnostic algorithm. The authors of this paper studied the significance and characteristics of vomiting in children with minor TBI.