PEDIATRIC HEAD INJURY

Minor trauma to the head is common in childhood and does not require any medical or surgical treatment. Nevertheless, head injury in infancy and childhood is the single most common causeof death and permanent disability. Measurabledeficits occur even after mild to moderate head injury but aremarkedly greater after severe injury. They include impairedcognition, motor impairments, disruption of attention and informationprocessing, and psychiatric disturbances. Despite the frequency of the sequelae of head injury in childhood, there is relatively little information about the structuralbasis of the clinical deficits. Classical literature suggests that the immature brain and its coverings, at a time when it is rapidly acquiring new information, respond differently from the adult brain when subjected to an equivalent amount of mechanicalforce, whether mediated by contact or inertial loading. Identification of different patterns of injury in differentage groups has resonance in clinical practice and now providesa reference point for future clinical and neuropathologicalstudies. This work not only provides the basis for the future management of patients, but also serves to remind us of thecontinuing value of the autopsy and the proper examination of retained organs using modern standardized techniques.