Head Trauma in Infants

February 13, 2013

Baby's_hand.JPG Head trauma accounts for more than 80 percent of death in children over the age of one year. In about 5 percent of situations, the child dies instantly from the trauma. Head injuries are complex, often requiring long stays in the hospital. There exists the need for approximately ten percent of infants requiring long term care with a medical facility after discharge.

Common causes of head injuries in infants and small children include assaults, motor vehicle accidents, child abuse and recreational activities. There can be a combination of primary injuries like scalp wounds, skull fracture, concussion, basilar skull fracture, subarachnoid hemorrhage, subdural hemorrhage and contusions.

There can be any one of the above primary injuries on top of many possible secondary injuries. Among the primary injuries, there can be a scalp injury. It can be overlying a skull fracture, called an open fracture of the skull. Scalp lacerations can be serious, especially in an infant as they can lead to hypotension and shock. A birth injury called the caput succedaneum is when there is a large blood clot between two layers of bone in the scalp. The blood loss is not as much because the bleeding stops at the suture lines.

A skull fracture in an infant can be linear, diastatic, depressed or comminuted. Ninety percent of all fractures are simply linear and may have an overlying laceration. Diastatic fractures have some distance between the fracture ends. There can be cerebrospinal fluid leaking through the laceration. A major blood vessel can cross over the open fracture, yielding a great deal of bleeding.

In a depressed skull fracture, an inner table of bone is pushing in on the brain. This is dangerous because it can damage the fragile brain tissue and can cause bleeding in the brain. This needs to be treated surgically so that the bony table can be at a normal level again. A third of depressed fractures are considered simple, a third cause a laceration of the dura covering the brain and a fourth have cortical lacerations.

A basilar skull fracture happens in up to 14 percent of pediatric head trauma patients. It occurs most whenever there is a blow to the back of the head. Symptoms that follow can include loss of consciousness, seizures and other neurological symptoms. Doctors may find a Battle sign or Raccoon eyes--areas of bruising that are indicative of a basilar skull fracture. Some of these finding occur in up to 10 percent of all cases of basilar skull fracture.

A concussion can occur if the head trauma is mild. Patients often show few signs of neurological damage; however, infants can show somnolence, vomiting and post traumatic seizures. Older children will exhibit post traumatic amnesia of the events after the concussion.

Brain tissue can be contused by the head trauma. This is caused by a direct blow to the head. The most vulnerable areas are the temporal and frontal lobes of the brain. Along with the contusion there can be edema of the brain and increased pressure around the brain which can result in death.

Handling a legal battle due to the death of an infant can be a painful process. It would be good to enlist a compassionate legal office to handle this matter for you. Please feel free to contact the Law Offices of Edward A. Smith to handle matters of this nature for you.

(Photo Attributed to Portraitlady4306 via Wikimedia Commons)

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