Pediatric head trauma.

Head trauma is a frequent cause of morbidity and mortality in the pediatric population. The type of injury that results depends on the mechanism of trauma and the age of the patient. Newborns, after difficult delivery, may have posteriorly located subdural hematomas owing to tearing of tentorium and venous structures. Young infants are particularly susceptible to shaking injury because of their weak neck muscles and thus may sustain subdural hematomas, shearing injuries, and diffuse swelling. As the child becomes mobile, falls become the number one cause of accidental injury, frequently producing fractures and contusions. In older children and teenagers, motor vehicle accidents predominate as the cause of severe head injury, particularly DAI. By appreciating these and other pertinent factors, the radiologist knows what to search for in a study; knows which modality, CT or MR, to use; and can frequently indicate the prognosis. Most importantly, the radiologist may be the first one to bring attention to the possibility of child abuse.