Crush head injuries in infants and young children: Neurologic and neuropsychologic sequelae

Neurologic and neuropsychologic sequelae of crush head injury, which is pro duced by static forces occurring when the head is stationary and pinned aga inst a rigid structure, were studied prospectively in a series of eight chi ldren ranging in age from 13 to 32 months. Hospital course, computed tomogr aphic findings, and neurologic and developmental outcomes were examined. Al l children sustained pronounced cerebral trauma characterized by multiple f ractures throughout the calvaria, extra-axial hemorrhages, and parenchymal contusions. Cranial nerve injuries were noted in three and hemiparesis in t wo of the cases. Two months after the injury, 63% of the children displayed deficits in either IQ or motor functioning. One year after the injury, fiv e of the six children reevaluated had a good recovery. Motor scores were si gnificantly lower than cognitive scores at baseline and showed the greatest degree of improvement over time. Neuropsychologic outcome after brain inju ry produced by static loading of the head is more favorable than from traum atic brain injury associated with dynamic loading.