Depth of Infant Head Injury Can Help Identify Cause

Children under 3 more likely to have been abused if injuries are beyond superficial

MONDAY, March 29 (HealthDay News) -- Head injury depth can be a useful tool to assess the causes and mechanisms of acute cranial trauma in children under 3 years of age, according to a study published online March 29 in Pediatrics.

Kent P. Hymel, M.D., of Dartmouth Medical School in Lebanon, N.H., and colleagues conducted a study of 54 children aged below 36 months who were hospitalized with acute head trauma. The researchers categorized the greatest depth of visible injury and found that 20 had scalp, skull or epidural injury, 13 had subarachnoid or subdural trauma, while cortical and subcortical injury were found in 10 and 11 subjects, respectively.

At the six-month mark, 27 of the children underwent a neurodevelopmental assessment. When the researchers compared children with subcortical injuries with those who sustained more superficial trauma, they found that these children were more likely to have been abused, to have compromised respiration and circulation, and to have acute encephalopathy and other signs of brain damage as well as lower scores for both mental and gross motor development.

"Infants and young children who demonstrate visible subcortical injuries unrelated to a motor vehicle crash require thorough evaluation for abuse," the authors write. "These results have diagnostic, prognostic, and forensic significance."

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