Extent and distribution of vascular brain injury in pediatric road fatalities

This study used a multidisciplinary approach to examine the brains of pedia tric road trauma fatalities in the Sydney area over a 3-year period. The br ains of 32 children (0-16 years) were examined: 20 pedestrians, nine passen gers, and three cyclists. The extent and distribution of brain injury was a ssessed, peak linear head acceleration determined, and the severity of brai n damage was compared to that previously reported for adults using the same scoring method. Skull fractures (20/32) and subarachnoid haemorrhage (22/3 2) were the commonest head injuries. In general, the neuropathology was sim ilar to that seen in adults, with a high percentage of damage in the corpus callosum and gilding contusions within the subcortical white matter. Intra cerebral hemorrhage was relatively rare. For frontal and occipital head imp acts, the corpus callosum was the most injured part of the brain, followed by the deep central structures and the temporal lobes, whereas for lateral impacts, the injuries were more evenly distributed. Comparison of the curre nt data for children with the vascular injury sector scores reported for ad ults suggests that the brains of children are more severely damaged for the same peak linear head acceleration.