Title | Influence of age and fall type on head injuries in infants and toddlers. |
Publication Type | Journal Article |
Year of Publication | 2012 |
Authors | Ibrahim NG, Wood JN, Margulies SS, Christian CW |
Journal | Int J Dev Neurosci |
Volume | 30 |
Issue | 3 |
Pagination | 201-6 |
Date Published | 2012 May |
ISSN | 1873-474X |
Keywords | Accidental Falls, Age Distribution, Child, Preschool, Craniocerebral Trauma, Female, Humans, Infant, Infant, Newborn, Male, Pennsylvania, Prevalence, Risk Assessment, Risk Factors |
Abstract | UNLABELLED: Age-based differences in fall type and neuroanatomy in infants and toddlers may affect clinical presentations and injury patterns. OBJECTIVE: Our goal is to understand the influence of fall type and age on injuries to help guide clinical evaluation. DESIGN/SETTING/PARTICIPANTS: Retrospectively, 285 children 0-48 months with accidental head injury from a fall and brain imaging between 2000 and 2006 were categorized by age (infant ≤1 year and toddler=1-4 years) and fall type: low (≤3 ft), intermediate (>3 and <10 ft), high height falls (≥10 ft) and stair falls. OUTCOME MEASURES: Clinical manifestations were noted and head injuries separated into primary (bleeding) and secondary (hypoxia, edema). The influence of age and fall type on head injuries sustained was evaluated. RESULTS: Injury patterns in children <4 years varied with age. Despite similar injury severity scores, infants sustained more skull fractures than toddlers (71% vs. 39%). Of children with skull fractures, 11% had no evidence of scalp/facial soft tissue swelling. Of the patients with primary intracranial injury, 30% had no skull fracture and 8% had neither skull fracture nor cranial soft tissue injury. Low height falls resulted in primary intracranial injury without soft tissue or skull injury in infants (6%) and toddlers (16%). CONCLUSIONS: Within a given fall type, age-related differences in injuries exist between infants and toddlers. When interpreting a fall history, clinicians must consider the fall type and influence of age on resulting injury. For young children, intracranial injury is not always accompanied by external manifestations of their injury. |
DOI | 10.1016/j.ijdevneu.2011.10.007 |
Alternate Journal | Int. J. Dev. Neurosci. |
PubMed ID | 22079853 |
PubMed Central ID | PMC3288448 |
Grant List | R01 NS039679 / NS / NINDS NIH HHS / United States R01 NS039679-09 / NS / NINDS NIH HHS / United States R01NS 39679 / NS / NINDS NIH HHS / United States |