Related Experiment Video
Updated: Sep 26, 2026
Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
Published on: January 20, 2023
Child head injuries: review of pattern from abusive and unintentional causes resulting in hospitalization
George W Brown1, Patrick Malone
1Dept. of Pediatrics, University of Vermont College of Medicine, USA. bro1406@acsalaska.net
Insights
Abused children hospitalized for head injuries experienced more severe central nervous system (CNS) damage than unintentionally injured children. Healthcare providers need enhanced training to better identify abusive head trauma in young children.
Area of Science:
- Pediatrics
- Trauma Surgery
- Child Abuse Prevention
Background:
- Head injuries are a significant cause of hospitalization in children.
- Distinguishing between unintentional and intentional (abusive) head injuries is crucial for appropriate management and intervention.
Purpose of the Study:
- To compare the patterns and severity of head injuries in hospitalized children, differentiating between unintentional injuries and those resulting from abuse, including Shaken Baby Syndrome.
- To identify demographic and injury-specific characteristics associated with abusive head trauma.
Main Methods:
- A retrospective review of medical records for children aged 0-4 years admitted with head injuries between 1993 and 1999.
- Data collected included demographics, injury mechanism, injury severity, central nervous system (CNS) sequelae, and investigation quality.
Main Results:
- Of 85 children, 73 were unintentionally injured and 12 were victims of abuse.
- Abused children, though fewer in number, had a significantly higher rate of serious CNS injury (42%) compared to unintentionally injured children (10%).
- Falls were the most common cause of unintentional injury (53%), while abuse accounted for 14% of all hospitalizations.
Conclusions:
- Demographic patterns of pediatric head injuries in Vermont align with national data.
- Abusive head injuries are associated with significantly greater severity, particularly CNS sequelae.
- Enhanced training for primary healthcare providers is recommended to improve the diagnostic index of suspicion for abusive head injuries.
Objective:
Comparison of patterns of hospitalized child head injuries among unintentionally injured with intentional Shaken Baby Syndrome and Abused victims.
Methods:
Medical records of children birth to 4 years of age admitted to the Fletcher Allen Health Care Hospital in the years 1993 to 1999 for head injury due to any cause were reviewed. Reviews which included age, gender, site of injury, caretaker of child, mechanism of injury, time of injury, severity of injury, CNS sequelae, and quality of investigation were completed for each child.
Results:
Of the total of 85 records reviewed, 49 were male and 36 female with a mean age of 18.9 months. Seventy-three children were injured unintentionally. Twelve were victims of intentional actions. Fifty-three percent of the unintentionally injured were male and 83% of the abused were male. Falls caused 53%, motor vehicles 17%, abuse 14%, of all the 85 hospitalized children. Only three deaths occurred among the 85 children, all from motor vehicle crashes. Forty-two percent of the 12 abused victims suffered serious CNS injury compared to only 10% among the unintentionally injured. Earlier symptoms and signs of abuse were missed in four of the 12 abused children.
Conclusions:
Demographic patterns of children hospitalized in Vermont for head injuries are similar to other state and national studies. Severity of injury is significantly higher for abused children. Primary health care providers should receive training emphasizing higher diagnostic index of suspicion for abusive head injuries.
