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Childhood Falls With Occipital Impacts
Norrell Atkinson, Rick R van Rijn1, Suzanne P Starling
1Emma Children's Hospital-Academic Medical Center Amsterdam, the Netherlands.
Pediatric Emergency Care
|June 8, 2017
Summary
Short falls with occipital impact can cause subdural hemorrhage (SDH) in young children. Accidental injury should be considered in trauma evaluations when a fall history is present.
Area of Science:
- Pediatric Traumatology
- Neuroscience
- Child Abuse Pediatrics
Background:
- Falls are frequently reported in children with brain injuries, both accidental and inflicted.
- Short falls are typically associated with minor injuries, but this study examines a specific scenario.
Purpose of the Study:
- To describe a series of short fall cases involving occipital impact resulting in subdural hemorrhage (SDH).
- To investigate the potential for accidental injury in cases of pediatric SDH following occipital impact.
Main Methods:
- Analysis of 8 witnessed cases of young children diagnosed with SDH after a short fall with occipital impact.
- Survey of child-abuse physicians regarding evaluation of children under 24 months with SDH after witnessed falls.
Main Results:
- Median age of affected children was 12.5 months; all fell backward onto hard surfaces.
- Most children had enlarged head circumferences and unilateral convexity SDH; all had retinal hemorrhages.
- The majority of children recovered to baseline within 24 hours of hospitalization.
Conclusions:
- Accidental injury should be considered in trauma workups when a history of a fall with occipital impact is elicited.
- Further research is needed to fully understand the spectrum of injuries from such falls.
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