Kids' Headaches Don't Need More Radiation

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CT scans for headaches in children should not be given but frequently are

June 23, 2013 / Author:  / Reviewed by: Dominique Brooks, M.D Beth Bolt, RPh

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(dailyRx News) Often, getting more tests and treatment for an illness is not better. In fact, it might actually lead to other problems. That's part of the reason CT scans aren't recommended for kids' headaches.

A recent study, however, found that children were frequently given CT scans for headaches anyway.

CT scans are images of a child's brain taken in "slices." However, they do not provide useful information to doctors for headaches when the child has a normal medical history.

Children were more likely to get a CT scan for headaches if they went to the ER than if they saw other doctors. They were less likely to get a CT scan if they saw a neurologist than other doctors.

"Ask doctors about the necessity of CT scans."

The study, led by Andrea DeVries, PhD, of HealthCore, Inc. in Wilmington, Delaware, looked at the use of CT scans in children with headaches.

CT scans, or computerized tomography scans, are done by taking a series of X-ray images from different angles and then combining them together in a computer.

The different angles and sections include images of bones and soft tissue. They are cross-sections similar to the different slices in a loaf of bread.

CT scans are currently not recommended for children with a regular medical history who suffer from headaches.

However, doctors still might give children CT scans even though it's not necessary. The radiation from CT scans has recently been linked to an increased risk for cancer in children.

Therefore, this study aimed to find out how commonly these unnecessary scans are given and under what circumstances.

The researchers reviewed insurance claims for 15,836 children, aged 3 to 17, who had gone to the doctor at least twice for a headache.

About one quarter of these patients (26 percent; 4,034 patients) had been given at least one CT scan.

Of these patients, 74 percent were given the CT scan within the first month after they were diagnosed with a headache.

The researchers found that children going to the emergency department for a headache were about four times more likely to get a CT scan than those who did not use the ER.

But the ER was certainly not the only clinical place that children were given CT scans. About two-thirds of the children who got CT scans never went to the ER.

Of the children who did not go to the ER, more than 20 percent (one-fifth) of them were given a CT scan.

The children who were least likely to undergo a CT scan were those seen by a neurologist, a doctor who specializes in illnesses of the head, brain and nervous system.

Children who saw a neurologist for a headache were 63 percent less likely to be given a CT scan.

"Use of CT scans to diagnose pediatric headache remains high despite existing guidelines, low diagnostic yield, and high potential risk," the researchers wrote.

A "low diagnostic yield" means that scans do not give the doctors a lot of useful information to use in making a diagnosis or deciding on treatment.

This study was published June 24 in the journal Pediatrics. The research was funded by WellPoint, Inc.

Two authors are employees of HealthCore, Inc., an independent research organization that received funding from WellPoint, Inc.

Two other authors are employees of WellPoint, Inc. The other authors reported no potential conflicts of interest.