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Re: Important factors in infant head injury.

Dear Editor,

We read with interest the well written article on infant head injury [1]. We agree with the authors that there is little published data on head injury specific to this age group.

The authors of this study do not comment on the distribution of head injury with age from birth to one year. Our own study of 108 infants, presenting over a two year period, suggests there may be a prevalence of more severe head injury in the younger child [2]. Specifically, 20 (19%) children were under 4 months, and 4 (20%) of these had major head injury. This contrasts with only 1 (1%) major head injury in 88 children over 4 months. Further analysis has revealed that the pattern of causation is different between these two groups. The younger immobile children have predominately been dropped while being carried. This may result in fall from a greater height, and subsequent greater injury.

It is important to recognise that head injuries, presenting to emergency departments, may not be equally distributed through the first twelve months of life in terms of numbers, mechanism of injury and likelihood of serious head injury. We would suggest that children under 4months need especially close attention when presenting with head injury.

J. Gray P. O’Connor S. McGovern

References

1. Browning J, Reed M J, Wilkinson, A G , Beattie T. Imaging infants with head injury: effect of a change in policy. Emerg Med J 2005;22: 33- 36.