Air bag-related deaths and serious injuries in children: injury patterns and imaging findings.
OBJECTIVE
As of November 1, 1997, automotive air-bag deployments occurring in low-speed collisions had resulted in the deaths of 49 children and in the serious injuries of 19 children in the United States. The purpose of this study was to investigate the patterns of injury occurring in this new mechanism of pediatric trauma.


METHODS
In search of common patterns of injury, three pediatric radiologists retrospectively evaluated the available autopsy and imaging studies in 11 such cases not previously reported in the medical literature, in addition to three published case studies.


RESULTS
The cause of death or serious injury in every case was the direct result of neurologic injury. Injury patterns differed according to the child's age and type of restraint used at the time of collision. Crush injury to the skull predominated in infant victims traveling in rear-facing child safety seats, and both cranial and cervical spine trauma occurred in older children traveling restrained, improperly restrained, or unrestrained in the vehicle's front passenger seat.


CONCLUSIONS
Air-bag systems pose a potentially fatal threat to the front-seat child passenger. This is directly related to the biomechanics at impact placing the child closer to the deploying air bag. An understanding of the biomechanics provides the radiologist insight into the two types of injury patterns observed.
Marshall
K W
KW
Section of Pediatric Radiology, University of Michigan Health Systems, Ann Arbor 48109, USA.
Koch
B L
BL
Egelhoff
J C
JC
D017278:Air Bags / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D015370:Infant Equipment; D008297:Male; D012189:Retrospective Studies; D012886:Skull / Q000000981:diagnostic imaging / Q000293:injuries*; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology*