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Crush head injuries in infants and young children neurologic and neuropsychologic sequelae

M R Prasad1, L Ewing-Cobbs, J Baumgartner

  • 1Department of Pediatrics, University of Texas Houston Health Science Center, 77030, USA.

Journal of Child Neurology
|August 24, 1999
PubMed

Insights

Crush head injuries in young children can cause severe brain trauma, but outcomes may be better than other head injuries. Most children showed improvement in cognitive and motor skills over time.

Area of Science:

  • Pediatric Neurology
  • Neurotraumatology
  • Developmental Psychology

Background:

  • Crush head injury results from static forces impacting a stationary head.
  • This type of injury is distinct from dynamic loading traumatic brain injuries.
  • Understanding the sequelae is crucial for pediatric neurotrauma management.

Purpose of the Study:

  • To prospectively examine the neurologic and neuropsychologic outcomes of crush head injuries in young children.
  • To characterize the hospital course, CT findings, and developmental trajectories.
  • To compare outcomes with traumatic brain injuries from dynamic loading.

Main Methods:

  • Prospective study of eight children (13-32 months) with crush head injuries.
  • Assessment of hospital course, neuroimaging (CT scans), and neurologic examinations.
  • Evaluation of developmental outcomes, including IQ and motor functioning, at 2 months and 1 year post-injury.

Main Results:

  • All children experienced severe cerebral trauma, including calvarial fractures, hemorrhages, and contusions.
  • Neurologic deficits such as cranial nerve injuries and hemiparesis were observed.
  • At 2 months, 63% of children had cognitive or motor deficits; however, 5 of 6 reevaluated at 1 year showed good recovery.
  • Motor scores improved significantly over time, surpassing cognitive score gains.

Conclusions:

  • Crush head injuries in infants and toddlers lead to significant initial cerebral trauma.
  • Despite initial deficits, a favorable recovery trajectory is possible, particularly in motor function.
  • Neuropsychologic outcomes appear more favorable compared to traumatic brain injuries from dynamic forces.

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