AIR BAG-RELATED DEATHS AND SERIOUS INJURIES IN CHILDREN - INJURY PATTERNS AND IMAGING FINDINGS

BACKGROUND AND PURPOSE: As of November 1, 1997, automotive air-bag dep loyments occurring in low-speed collisions had resulted in the deaths of 49 children and in the serious injuries of 19 children in the Unite d States. The purpose of this study was to investigate the patterns of injury occurring in this new mechanism of pediatric trauma. METHODS: In search of common patterns of injury, three pediatric radiologists r etrospectively evaluated the available autopsy and imaging studies in 11 such cases not previously reported in the medical literature, in ad dition to three published case studies. RESULTS: The cause of death or serious injury in every case was the direct result of neurologic inju ry. Injury patterns differed according to the child's age and type of restraint used at the time of collision. Crush injury to the skull pre dominated in infant victims traveling in rear-facing child safety seat s, and both cranial and cervical spine trauma occurred in older childr en traveling restrained, improperly restrained, or unrestrained in the vehicle's front passenger seat. CONCLUSION: Air-bag systems pose a po tentially fatal threat to the front-seat child passenger. This is dire ctly related to the biomechanics at impact placing the child closer to the deploying air bag, An understanding of the biomechanics provides the radiologist insight into the two types of injury patterns observed .