title: Traumatic head injury in infants and toddlers.
abstract: OBJECTIVE
  To describe the presenting characteristics, type of injury and hospital course in young children with traumatic head injury, and to identify characteristics indicating that the trauma was inflicted.
  
  
  METHODS
  A retrospective medical record review of 91 children less than 3 years of age who were admitted to a tertiary teaching hospital in Norway from 1995 through 2005 with a traumatic head injury. Patients were identified by diagnostic codes, and categorized by type of injury as skull fractures (n = 39), epidural haemorrhage (EDH) (n = 12), subdural haemorrhage (n = 27) and parenchymal brain injury (n = 13). Further the cases were classified as inflicted injury (n = 17), accident (n = 35) or indeterminate (n = 39).
  
  
  RESULTS
  The mechanism of injury was similar for EDHs and isolated skull fractures, and none were classified as inflicted. Sixty-three percent of the cases with subdural haematoma were classified as inflicted. When compared to the accident group, children in the inflicted group more frequently had subdural haemorrhage without a skull fracture (OR = 6.9, CI = 1.7-28.2), and seizures (OR = 9.5, CI = 2.1-43.3).
  
  
  CONCLUSIONS
  Inflicted and accidental head injuries differed in presenting characteristics and injury type. Nearly two-third of the subdural haemorrhages were classified as inflicted, but none of the epidural EDHs or skull fractures. Inflicted injuries tended to present with seizures.
authors.affiliation: Department of Paediatric Intensive Care, Ullevål University Hospital, Oslo, Norway. mimy@uus.no
authors.forename: M C
authors.initials: MC
authors.lastname: Myhre
authors.forename: J B
authors.initials: JB
authors.lastname: Grøgaard
authors.forename: G A
authors.initials: GA
authors.lastname: Dyb
authors.forename: L
authors.initials: L
authors.lastname: Sandvik
authors.forename: M
authors.initials: M
authors.lastname: Nordhov
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic; D001930:Brain Injuries / Q000453:epidemiology / Q000209:etiology*; D002649:Child Abuse; D002675:Child, Preschool; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000453:epidemiology / Q000209:etiology*; D006408:Hematoma, Subdural / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D009664:Norway / Q000453:epidemiology; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D012887:Skull Fractures / Q000453:epidemiology / Q000209:etiology*; D015996:Survival Rate