In a pediatric patient with a head injury and a GCS less than 14, what is the best investigation?

In the case of a pediatric patient who has sustained a head injury and has a Glasgow Coma Scale (GCS) score of less than 14, the most appropriate investigation is a CT scan.

A GCS score below 14 indicates a moderate to severe head injury, raising concerns about potential intracranial complications like hemorrhages, contusions, or skull fractures. A CT scan is favored in these scenarios because it provides rapid assessment of the brain's anatomy and can effectively identify acute traumatic conditions such as bleeding or swelling. It is particularly useful in emergency settings due to its accessibility and speed, allowing for timely intervention if necessary.

Other imaging modalities, while useful in different contexts, are not optimal for initial assessment of acute head injuries. For instance, facial X-rays are focused on facial bones and would not give information about the brain or intracranial structures. Conventional X-rays primarily evaluate for skull fractures but are limited in assessing soft tissue and brain injury. MRI offers excellent detail for soft tissues and chronic brain injuries but is not suitable in acute settings due to longer acquisition times and the need for the patient to remain still, which may not be feasible for unstable or agitated individuals. Thus, the CT scan is the best choice for evaluating a