Traumatic head injury in infants and toddlers

Acta Paediatr. 2007 Aug;96(8):1159-63. doi: 10.1111/j.1651-2227.2007.00356.x. Epub 2007 Jun 18.


Aim: 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.

MeSH terms

  • Accidental Falls
  • Accidents, Traffic
  • Brain Injuries / epidemiology
  • Brain Injuries / etiology*
  • Child Abuse*
  • Child, Preschool
  • Female
  • Hematoma, Epidural, Cranial / epidemiology
  • Hematoma, Epidural, Cranial / etiology*
  • Hematoma, Subdural / epidemiology
  • Hematoma, Subdural / etiology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Infant
  • Length of Stay / statistics & numerical data
  • Longitudinal Studies
  • Male
  • Norway / epidemiology
  • Retrospective Studies
  • Seizures / etiology
  • Skull Fractures / epidemiology
  • Skull Fractures / etiology*
  • Survival Rate