Pediatric Head Injury

Minor trauma to the head is common in childhood and does not requireany medical or surgical treatment. Nevertheless, head injury in infancyand childhood is the single most common cause of death and permanentdisability. Measurable deficits occur even after mild to moderate head injurybut are markedly greater after severe injury. They include impaired cognition,motor impairments, disruption of attention and information processing, andpsychiatric disturbances. Despite the frequency of the sequelae of head injuryin childhood, there is relatively little information about the structural basisof the clinical deficits. Classical literature suggests that the immature brainand its coverings, at a time when it is rapidly acquiring new information,respond differently from the adult brain when subjected to an equivalentamount of mechanical force, whether mediated by contact or inertial loading.Identification of different patterns of injury in different age groups has resonancein clinical practice and now provides a reference point for future clinical andneuropathological studies. This work not only provides the basis for the futuremanagement of patients, but also serves to remind us of the continuing valueof the autopsy and the proper examination of retained organs using modernstandardized techniques.