Pediatric skull fractures and intracranial injuries

Abstract

The determination of plausibility of an injury arising from a fall leading to head trauma is a great challenge especially in young children. The present review is aimed to discuss important developments in the filed of head trauma cases especially in children. We explored various studies pertaining to head trauma injuries in children by exploring mainly PubMed, Google scholar and some library periodicals available in our library. Studies in the recent past explored the head injuries as a result of a low height fall. However, there are great amount of difficulties in assessment of height with certainty that caused head injuries like skull fracture or intracranial injury. Biomechanical thresholds have been estimated for young children for injuries such as skull fracture, but they have not been assessed against the injuries observed in a clinical setting. So, this review discusses current aspects of pediatric head injuries ranging from a minor head injury to a skull fracture. The present review concludes that recording full details of cause of head trauma such as fall height is essential for proper treatment planning and efficient management.

Globe trauma associated with falls at Australian tertiary centres

“…Our findings are consistent with Guly et al who conducted a retrospective analysis of a Trauma Audit Research Network database from England and Wales between 1989 and 2004. They found the risk of globe trauma for patients with facial fractures was 6.7 times greater compared to patients with no Orbital/mid-facial fracture 110 (16) Laceration to lids or adnexa 36 (10) Open globe injury 25 (7) Internal eye injury 25 (7) Corneal trauma 15 (4)…”

“…8,9 Pre-ambulant children can also be at greater risk of falls while developing their coordination and strength. 10,11 The risk of trauma is increased in the elderly due to the frequency of falls and underlying comorbidities. 1,2 Ten percent of falls in the elderly cause serious trauma, such as fractures, head and globe injuries.…”

Computed tomography of traumatic brain injury in infants and young children (a literature review)

“…• Переломы основания черепа редко встречаются у детей (26%), подразделяются на переломы передней, средней и задней черепной ямки. Возможно также сочетание переломов свода и основания черепа [30,[44][45][46][47][48][49]. В возрастных группах, где лицевые кости еще развиваются, они могут привести к травмам черепных нервов и сосудов [52,72].…”

“…КТ головного мозга с 3D-реконструкцией четко и без дифференциально-диагностических проблем выявляет костный диастаз (диастатический перелом) и мозговые грыжи. Факторами, способствующими возникновению растущего перелома, являются пульсация головного мозга и ликвора и повышенное внутричерепное давление[47,52,53, 56, 57, 69-71]. Девочка 6 мес, упала со второго яруса кровати.…”

Traumatic Brain Injury in Children

“…Longer duration at a lower magnitude of RA generates diffuse axonal injury, and the opposite generates subdural hematoma. Although LA and RA are often described separately, the inherent coupling of both forces is inevitable in reality [16,17].…”