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Head injuries in kids

A study in which more than 43,000 children were evaluated for head trauma offers an unprecedented picture of how children most frequently suffer head injuries, report physicians at Washington University School of Medicine and the University of California, Davis, School of Medicine.

IN A STUDY OF CHILDREN EVALUATED AT HOSPITALS FOR HEAD TRAUMA, PHYSICIANS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS, THE UNIVERSITY OF CALIFORNIA, DAVIS, AND ELSEWHERE FOUND THAT THE CAUSES OF MANY HEAD INJURIES ARE A LITTLE BIT DIFFERENT THAN WHAT HAD PREVIOUSLY BEEN THOUGHT AND THAT AGE IS A PRETTY GOOD PREDICTOR OF WHAT TYPE OF INJURY A CHILD IS AT RISK FOR. JIM DRYDEN REPORTS…

HOW A HEAD INJURY OCCURS DEPENDS TO A GREAT EXTENT ON HOW OLD A CHILD HAPPENS TO BE, ACCORDING TO THE STUDY’S FIRST AUTHOR, KIMBERYLY QUAYLE, A WASHINGTON UNIVERSITY PEDIATRICIAN AND THE MEDICAL DIRECTOR OF EMERGENCY SERVICES AT ST. LOUIS CHILDREN’S HOSPITAL.

(act) :21 o/c an object

The most common causes of head injuries in children,

ages 12 and younger were falls – that included falls

from elevations; it included falls down stairs. And

then for children between the ages of 2 and 12 years,

falls were number one and two, and number three was

being struck by an object.

THAT COULD BE A BALL OR A BAT, A STICK OR SOME OTHER OBJECT. MEANWHILE, QUAYLE SAYS IN OLDER TEENAGERS, THE CAUSES OF HEAD INJURY ARE DIFFERENT.

(act) :19 o/c more common

In teenagers, the leading causes of injury were assaults,

sports activities and motor vehicle crashes. And that is

something that was a little bit different than what has

been previously reported. Previously, it was usually motor

vehicle crashes were more common.

IN SOME WAYS, QUAYLE SAYS THE CAUSES OF INJURIES ARE SOMEWHAT PREDICTABLE. SHE SAYS WHAT’S LIKELY TO HURT A CHILD IS DETERMINED, AT LEAST PARTLY, BY WHAT A CHILD IS LIKELY TO BE DOING AT A PARTICULAR STAGE OF LIFE.

(act) :23 o/c and fights

So if you think about what a 2-year-old, or younger,

is likely to be doing, they’re more likely to be

climbing on things and falling, running an falling,

perhaps being carried and dropped. As children get

older, they’re more likely to be involved in other

activities. And certainly by the time they’re teenagers,

more likely to be in cars, more likely to be involved

in assaults and fights.

QUAYLE ADMITS IT CAN BE VERY DIFFICULT TO PREVENT SOME OF THE INJURIES THAT WERE SEEN DURING THE STUDY.

(act) :13 o/c up with

It’s difficult to prevent all falls in young children

because they’re very busy. They’re difficult to keep

up with, and I think, you have opportunities where

they are, they are moving much quicker than parents

can keep up with.

THE RESEARCHERS FOUND THAT NEARLY 98 PERCENT OF THE CHILDREN IN THE STUDY HAD MILD HEAD TRAUMA. SOME 37 PERCENT UNDERWENT CT SCANS TO CHECK FOR TRAUMATIC BRAIN INJURIES, BUT IT TURNED OUT THAT ONLY 7 PERCENT OF THE CHILDREN WHO WERE SCANNED ACTUALLY HAD SUCH AN INJURY, SUGGESTING THAT CT SCANS MAY BE OVERUSED AS A DIAGNOSTIC TOOL IN THIS POPULATION. ANOTHER SURPRISING FINDING, QUAYLE SAYS, WAS THAT A LARGE NUMBER OF THE CHILDREN WHO WERE INJURED, BOTH YOUNG AND OLD, WEREN’T PROTECTED AS WELL AS THEY COULD HAVE BEEN IF THEY, OR THEIR PARENTS, HAD TAKEN A FEW SIMPLE STEPS.

(act) :24 o/c the car

Bicycle helmets were not used frequently, so we would

certainly encourage parents to use bicycle helmets. Seat

belts were used, or child-restraint seats were used, only

about two-thirds of the time in all of the patients with

head injuries, so we would certainly encourage them to

make sure they’re using their child-restraint seats

properly and to encourage their children to “buckle up”

while they’re in the car.

QUAYLE AND HER COLLEAGUES REPORT THEIR FINDINGS IN THE NEW ENGLAND JOURNAL OF MEDICINE. I’M JIM DRYDEN.

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