Accidental traumatic head injury in infants and young children.
This article will discuss accidental head injuries in infants and young children. The first category of injury is the crushing head injury. Static forces applied slowly to the head result in multiple fractures of the skull and contusions and lacerations of the brain resulting from the bone fragments striking the brain. This article will discuss the subject of short falls in young children and the resulting head injuries. Because falls are frequent events in early life, many cases have been collected and many papers written on the subject. Study of these cases is informative about the injuries likely to occur in these falls. Most often, only a minor contact injury such as scalp bruise or laceration results. In a 2 to 3% of falls, a simple linear skull fracture occurs and the majority of these are uneventful in terms of neurological deficit or intracranial bleeding. In about 1% of the fractures, an epidural or subdural hemorrhage occurs. Each of these forms of contact hemorrhages will be discussed and illustrated. While these are relatively rare injuries, it is essential that they can be identified as consistent with an accidental mechanism so that an erroneous diagnosis of inflicted injury is not made.
Case
Mary E
ME
Department of Pathology, Division of Forensic Pathology, St. Louis University School of Medicine, St. Louis, MO 63104, USA. mcase@stlouisco.com
D000058:Accidental Falls; D000059:Accidents; D000063:Accidents, Traffic; D000367:Age Factors; D001930:Brain Injuries / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D002675:Child, Preschool; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D046648:Hematoma, Subdural, Intracranial / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012886:Skull / Q000293:injuries / Q000473:pathology; D012887:Skull Fractures / Q000150:complications / Q000209:etiology / Q000473:pathology*
Arch Pediatr Adolesc Med. 2003 May;157(5):480-6
12742885
J Neurotrauma. 1997 Jul;14(7):419-40
9257661
Pediatrics. 1977 Oct;60(4):533-5
905018
J Trauma. 1991 Oct;31(10):1350-2
1942141
Pediatrics. 1969 Nov;44(5):Suppl:869-76
5375003
Childs Nerv Syst. 1988 Feb;4(1):34-40
3401866
J Child Neurol. 1999 Aug;14(8):496-501
10456758
J Pediatr Surg. 1983 Aug;18(4):509-11
6620098
J Forensic Sci. 2008 Mar;53(2):479-82
18366585
Arch Pathol. 1963 Apr;75:402-13
13959668
Arch Phys Med Rehabil. 2001 Oct;82(10):1461-71
11588754
Am J Forensic Med Pathol. 2003 Dec;24(4):371-6
14634479
Hum Pathol. 1980 Mar;11(2):155-66
6995266
J Trauma. 1993 Dec;35(6):968
8264004
Neurosurgery. 1995 Sep;37(3):401-6; discussion 407
7501102
J Neurosurg. 1968 Jul;29(1):13-23
5302643
J Trauma. 1991 Oct;31(10):1353-5
1942142
Acta Neurochir (Wien). 1997;139(4):273-8
9202765
J Pediatr Orthop. 1987 Mar-Apr;7(2):184-6
3558802
Br J Neurosurg. 2002 Jun;16(3):220-42
12201393
Surg Neurol. 1988 Nov;30(5):339-41
3055383
J Trauma. 1991 Oct;31(10):1347-9
1942140
Neurosurgery. 1988 Jul;23(1):44-51
3173664
Pediatrics. 1993 Jul;92(1):125-7
8516057