Elsevier

Injury

Volume 43, Issue 12, December 2012, Pages 2141-2145
Injury

Head injuries in children under 3 years

https://doi.org/10.1016/j.injury.2012.07.195Get rights and content

Abstract

Background

A significant number of children under 3 years sustain a head injury every year. Despite this few studies have provided detailed information about these injuries.

Methods

A retrospective review of the medical files all children aged 0–3 years who attended a paediatric emergency department for treatment over a 2-year period.

Results

Children aged 0–6 months had the highest rate of moderate head injury. Children under 12 months were at the greatest risk of injury. Falls were the most common cause of injury including falls from caregiver's arms.

Conclusions

Children under 12 months are at significant risk of head injury, many of these injuries could be prevented by increased parental supervision or improved home safety.

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.

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