Head injuries in children under 3 years
Section snippets
Method
The medical records of all children aged from birth to 36 months, who presented at the Emergency Department of the Royal Children's Hospital, Melbourne, Australia, after sustaining a head injury from 1st January 2004 to the 31st December 2005 were reviewed retrospectively. The Royal Children's Hospital is a tertiary paediatric hospital that services children from the local community as well as the state of Victoria. The following International Classification of Diseases 10th revision discharge
Results
Information was collected on a total of 721 head injured children aged 3 years and under, 348 from 2004 and 373 from 2005. There were 29 patients that were not included (16 were wrongly classified with further examination revealed incidents and injuries such as a seizure in child with epilepsy, lacerations to tongues or mouths, a stroke, etc.; 13 files were unavailable for review). The total 721 patients included four representations for the same injury (three children who represented a day
Discussion
The overall aim of this study was to detail and describe the epidemiology of head injury in children younger than 3 years. To do this, careful retrospective examination of the medical records for all children younger than 3 years of age who presented to the Emergency Department with a head injury for a 2-year period was carried out. Although this study's sample was much larger than published works in this area,11, 12, 13, 14 the findings were generally in keeping with past literature.
Children
Limitations
There are limitations to this study. Hospital-based studies may not be representative of the general population for incidence estimates calculated. Many children with mild head injury are likely to have been managed outside of a hospital context and therefore the full spectrum of mild head injury in young children cannot be ascertained from this study. Although the recommendations for optimal chart review were followed,18 the main concern is that the retrospective nature of this study means
Conclusions
This study found that children under 3 years frequently present to the emergency department for treatment following a head injury. Typically these injuries were caused by falls in the home. Children aged 0–6 months had the most moderate head injuries. Possible prevention could include information given to parents after birth on the risk of head injury through dropping their child or their child rolling off furniture. Information on holding techniques and awareness of when the infant will be
Conflict of interest
There are no conflicts of interest to report.
Acknowledgements
This study was supported by the Foundation for Children and the Victorian Government's Operational Infrastructure Support Program.
References (40)
- et al.
Accidental head injuries in children under 5 years of age
Clinical Radiology
(2005) - et al.
Chart reviews in emergency medicine research: where are the methods?
Annals of Emergency Medicine
(1996) - et al.
Acute subdural hematoma in infancy
Surgical Neurology
(2002) - et al.
Preschool children with mild to moderate traumatic brain injury: an exploration of immediate and post-acute morbidity
Archives of Clinical Neuropsychology
(2005) - et al.
Risk factors for childhood major and minor head and other injuries in a nationally representative sample
Injury
(2003) - et al.
Incidence of hospital-treated traumatic brain injury in an Australian community
Australian and New Zealand Journal of Public Health
(1998) - et al.
Brain injuries among infants, children, adolescents and young adults
American Journal of Diseases of Children
(1990) - et al.
Paediatric trauma: injury pattern and mortality in the UK
Archives of Disease in Childhood
(2009) - et al.
The epidemiology of paediatric head injuries: data from a referral centre in Victoria, Australia
Journal of Paediatrics and Child Health
(2009) Current incidence and management of children with traumatic head injuries: the Stockholm experience
Developmental Neurorehabilitation
(2007)
The epidemiology of urban pediatric neurological trauma: evaluation of, and implications for, injury prevention programs
Neurosurgery
Patterns of injury in children: a population-based approach
Pediatrics
Head injuries in children under 36 months of age: demography and outcome
Childs Nervous System
The neurological outcome of non-accidental head injury
Pediatric Rehabilitation
A population-based study of inflicted traumatic brain injury in young children
Journal of American Medical Association
Neurological and mental outcome after severe head injury in childhood: a long-term follow-up of 318 children
Disability and Rehabilitation
Head injury in very young children: mechanisms, injury types and ophthalmologic findings in 100 hospitalised patients younger than 2 years of age
Pediatrics
Severe head injury in early infancy: analysis of causes and possible predictive factors for outcome
Childs Nervous System
Traumatic head injury in infants and toddlers
Acta Paediatrica
International classification of diseases, 10th revision
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