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TitleClosed head injuries in infants and children: causes and outcomes
AuthorsSimpson DA
TypeConference Paper
AbstractThe epidemiology of lethal paediatric head and/or spinal injuries has been extensively studied; in a recent South Australian study, the rate in 1977 was 100 per 1,000,000 cases a t risk in the age group 0-4 and 92 per 1,000,000 in the age group 5-14; motor vehicle accidents caused about 70 percent of deaths in both age groups. Data for infants are less complete: in this age group the chief causes of lethal or disabling head injury are parturition, falls, assault by adults, and motor vehicle accidents: except in the l a s t category, documentation of the mechanics of injury is often very inadequate or unreliable. There is a need for further epidemiological study of non fatal injuries in infancy and childhood, using internationally accepted severity scales. The blunt head injuries of infants and young children often show age-specific peculiarities. These may reflect different impact patterns or may result from biological immaturity. The inmature skull is thin, flexible, and easily shattered; if a skull fracture in early life is associated with tearing of the bone forming dura mater, an expanding bone defect may result. The imnature brain may suffer local contusion or laceration; it has been said that contusions are less common than shearing in juries in childhood, but this assertion needs autopsy verification. The inmature brain is also said to be more prone to acute swelling after injury. The secondary effects of blunt injury in young people also show peculiarities; while extradural haemorrhage is often seen, subdural haemorrhage is quite unusual in older children but cannon during the first 12 months of life . The peculiarities of the chronic and acute-on-chronic subdural effusions of infancy remain unexplained. The outcomes of paediatric head injury also deserve more intensive study, using an internationally accepted system of evaluation. It has been argued that children recover from head injuries better and more quickly than adults; while this is true with respect to speech, it may be untrue for other cognitive functions. Learning difficulties are of ten reported af ter head injuries, and there is a need for research into the best educational strategies in such cases.
PublisherRoad Accident Research Unit
Publisher CityAdelaide
SponsorNational Health and Medical Research Council of Australia
Conference NameHead and Neck Injury in Road Accidents Symposium
Conference LocationAdelaide, Australia
Conference Date10-11 December 1985
Page Range95-101
Page Count7
Notesavailable from CASR library on request

Simpson DA (1988). Closed head injuries in infants and children: causes and outcomes. Head and Neck Injury in Road Accidents Symposium, (pp. 95-101). Adelaide: Road Accident Research Unit.