J. Berney et al., PEDIATRIC HEAD TRAUMA - INFLUENCE OF AGE AND SEX .2. BIOMECHANICAL AND ANATOMOCLINICAL CORRELATIONS, Child's nervous system, 10(8), 1994, pp. 517-523
A consecutive, unselected series of 1812 cases of head trauma in child
ren less than 15 years of age and admitted hospital over a period of 8
.5 years was studied. Data concerning the grade of energy involved, th
e ages of the victims, the types of pathologies caused and the clinica
l features noted were collected and statistically analysed. Babies and
toddlers (0-3 years) were shown to sustain rather low-energy trauma a
nd suffer more skull fractures, more subdural haematomas and more beni
gn injuries. They lost consciousness less frequently and were less fre
quently in coma than the other children. By contrast, they had more fr
equent signs of lateralization, and early seizures were much more freq
uent in babies than in other children. Young children (3-9 years) had
rather higher-energy accidents, frequently lost consciousness, were mo
re frequently in coma and have more frequently had a free interval ass
ociated with the development of brain swelling. They did not suffer su
bdural effusion or contrecoup lesions. Schoolchildren (9-15 years) wer
e statistically more or less like young adults: the clinical sequences
of trauma were more severe than in the other children, mortality was
a little bit higher, the risk of extradural haematoma was higher, and
they rarely suffered subdural haematomas or contrecoup lesions. Traffi
c accidents, with higher energy involved, were more severe.