Department of Legal Medicine, Hôpital Saint Jean, Perpignan Hospital Center, Perpignan, France.
Department of Legal Medicine, Hôpital de la Timone, Marseille University Hospital Center, Marseille, France; Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.
Leg Med (Tokyo). 2021 Mar;49:101846. doi: 10.1016/j.legalmed.2021.101846. Epub 2021 Jan 13.
Minor head trauma in the child, whether accidental or inflicted, is a frequent reason for seeking medical attention. Our aim is to describe the characteristics of minor head trauma in children aged 0-3 years and the resulting injuries. This in order to help the clinician to suspect and thelegal expert to confirm intentional abuse.
Children aged from 0 to 3 years with minor head trauma and attending the pediatric emergency department were included in the study between January 2013 and June 2014. The correlation between the characteristics of trauma and the resulting injuries was analyzed using a prospective data collection questionnaire completed by the physicians who cared for the child.
A total of 709 children with minor head trauma were included in the study. In nearly 90% of cases, fall height was less than 1 m. Only one-third of children aged less than 6 months had external head injury. Low-intensity trauma, such as a low-velocity fall from a height of less than 1.5 m does not cause intracranial injury. External injuries were more frequent in children who had a fall with an anterior impact, while internal injuries were found only in posterior and lateral impacts.
In the context of minor head trauma, the physician must be vigilant and must ask for a full and clear description of the trauma, its mechanisms and other characteristics, when external or internal head injuries are observed in children aged less than 6 months.
儿童头部受到轻微创伤，无论是意外还是人为，都是寻求医疗关注的常见原因。我们的目的是描述 0-3 岁儿童轻微头部创伤的特征和由此产生的损伤。这有助于临床医生怀疑并使法律专家确认故意虐待。
2013 年 1 月至 2014 年 6 月期间，我们研究了在儿科急诊就诊的 0-3 岁患有轻微头部创伤的儿童。使用医生完成的前瞻性数据收集问卷分析创伤特征与损伤结果之间的相关性。
共有 709 名患有轻微头部创伤的儿童纳入研究。近 90%的情况下，跌落高度小于 1 米。小于 6 个月的儿童中只有三分之一有头部外部损伤。低强度创伤，如低于 1.5 米的低速度跌落，不会造成颅内损伤。前向撞击的跌落会导致更频繁的外部损伤，而仅在后向和侧向撞击时才会发现内部损伤。
在轻微头部创伤的情况下，当观察到 6 个月以下儿童有外部或内部头部损伤时，医生必须保持警惕，并详细询问创伤及其机制等其他特征。
