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Evaluation of minor head trauma in children younger than two years
M Pietrzak1, A Jagoda, L Brown
1Division of Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799.
Insights
Pediatric blunt head injuries in children under 2 require careful evaluation due to immature bones. A low threshold for radiographic imaging is recommended to detect potential cranial injuries and complications.
Area of Science:
- Pediatric Emergency Medicine
- Radiology
- Pediatric Traumatology
Background:
- Skull films have limitations in evaluating minor head trauma.
- Limited emphasis exists on risks of blunt head injury in children under 2 years old.
- Immature bone and unfused sutures in young children increase cranial injury risk.
Abstract:
The recent medical literature emphasizes the limitations of skull films in the evaluation of minor head trauma. However, the emergency medicine literature places little emphasis on the particular risks in children younger than 2 years old with blunt head injury. These children have immature bone and unfused sutures that may increase risk of cranial injury and delayed complications. A case is presented to illustrate this point. Unlike severe head trauma, where evaluation is directed toward computed tomography, the literature continues to be controversial regarding the indications for skull radiographs and computed tomography in minor head trauma. The authors recommend a low threshold for radiographic imaging in blunt heat injuries in children younger than 2 years.