Trends in the anatomical location and injury mechanism of pediatric head trauma.

OBJECTIVE

Although pediatric head trauma (PHT) is a critical public health issue, comprehensive research on the anatomical distribution and frequency of impact locations is lacking. The authors aimed to elucidate trends in the mechanisms and anatomical locations of PHT using clinical data across all injury severity levels.

METHODS

The medical records of 146 PHT patients aged 0-14 years treated by the authors' neurosurgery department were analyzed, excluding cases of suspected abuse. Clinical data and injury mechanisms were reviewed, and 152 PHTs were assessed to identify the trauma frequencies for 17 different anatomical locations of the head. The authors compared actual to expected PHT hits per region based on area ratios to determine the regions more susceptible to PHT.

RESULTS

Most PHTs were minor, without even subcutaneous hematomas. Radiological imaging was performed in 32.2% of patients, revealing abnormalities in 19.2% of those cases. Larger hematomas correlated with these abnormalities, although there was no correlation between vomiting and imaging findings. Notably, 65.7% of the traumas occurred within a horizontal band from the frontal to the occipital region, similar to the area covered by a sports headband. The high injury concentration in this area was particularly focused on the center-forehead region, where susceptibility was significant (p < 0.001). Children younger than 6 years of age had a greater bias toward specific PHT-prone regions. This diminished with age, suggesting changing PHT mechanisms as children mature.

CONCLUSIONS

Certain head regions are more prone to accidental PHT, with region-specific susceptibility varying by age. This study can facilitate the design of optimal pediatric head protection and support clinical assessment of injury patterns.