Minor Head Trauma in Children Younger than 2 Years of Age

Kim, Jong Oh; Kim, Kyung Hwan; Kim, Sung Eun

Abstract

PURPOSE
The subjects of this study were minor head trauma patients under the age of two, this analyzing skull fracture (SF) and traumatic brain injury (TBI) were analyzed for the purpose of providing basic data for controlling the use of plain skull X-rays and Brain CTs and for selecting on approaches to treatment.
METHODS
We performed a 2-year retrospective review, and data were collected on historical features, physical findings, radiological findings, and hospital course.
RESULTS
Of 110 study subjects, 15 (13.6%) patients had SF/TBI. Falls were the most common cause of head injury (79.1%). 8 (9.2%) patients in falls had SF/TBI. Heights of fall above 1 m were associated with a higher incidence of SF/TBI (p<0.05). Children younger than 12 months had a higher incidence of SF/TBI (46.2% vs 2.7%) than children aged 13 to 24 months (p<0.05). Scalp abnormalities were more common in children with SF/TBI (p<0.05). The incidences of behavioral change, loss of consciousness, emesis, and seizures did not differ significantly between those with normal radiological findings and those with SF/TBI. For Falls from heights less than 1 m, infants older than 12 months with normal scalp findings showed no SF/TBI.
CONCLUSION
In this study, the plain skull X-ray and Brain CT were shown not to be necessary for infants older than 12 months with normal scalp findings and falls from heights of less than 1 m, provided there were no serious clinical symptoms.