Background: Fall is a common mechanism of infant minor head injury (MHI) with a small but clinically significant portion requiring urgent intervention. Decision rules aim to stratify risk while minimizing unnecessary tomography (CT) incorporating height of fall and mechanism of injury into decision algorithms. The evidence to support this is limited.
Aim: To examine fall related infant MHI, and explore possible associations between injury mechanisms and traumatic findings.
Design: Infants aged 0-2 years with MHI due to falls were prospectively enrolled at the pediatric ED of a tertiary children’s hospital. Demographic data and injury characteristics were recorded. Outcomes were positive findings on CT and neurosurgical intervention.
Results: 595 patients were included (mean age of 13 ± 6 months). Eight specific mechanisms were identified. 31 patients (5.2%) underwent tomography. Seventeen had traumatic findings. All of the patients who fell from adult hands had abnormal scans and one required neurosurgery. None of the ground level falls resulted in CT abnormalities. No statistically significant association was found between different mechanisms or height and study outcomes.
Conclusion: Specific mechanisms may be more significant than the reported height of fall in stratifying risk. Further studies are needed to clarify these factors in infants with MHI.
