Departmental Papers (BE)

Document Type

Journal Article

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Publication Source

International Journal of Developmental Neuroscience





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Age-based differences in fall type and neuroanatomy in infants and toddlers may affect clinical presentations and injury patterns.


Our goal is to understand the influence of fall type and age on injuries to help guide clinical evaluation.


Retrospectively, 285 children 0–48 months with accidental head injury from a fall and brain imaging between 2000 and 2006 were categorized by age (infan ≤ 1 year and toddler = 1–4 years) and fall type: low (≤3 ft), intermediate (>3 andft), high height falls (≥10 ft) and stair falls.

Outcome Measures

Clinical manifestations were noted and head injuries separated into primary (bleeding) and secondary (hypoxia, edema). The influence of age and fall type on head injuries sustained was evaluated.


Injury patterns in children scores, infants sustained more skull fractures than toddlers (71% vs. 39%). Of children with skull fractures, 11% had no evidence of scalp/facial soft tissue swelling. Of the patients with primary intracranial injury, 30% had no skull fracture and 8% had neither skull fracture nor cranial soft tissue injury. Low height falls resulted in primary intracranial injury without soft tissue or skull injury in infants (6%) and toddlers (16%).


Within a given fall type, age-related differences in injuries exist between infants and toddlers. When interpreting a fall history, clinicians must consider the fall type and influence of age on resulting injury. For young children, intracranial injury is not always accompanied by external manifestations of their injury.

Copyright/Permission Statement

This is the author’s version of a work that was accepted for publication in International Journal of Developmental Neuroscience. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms, may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in: Int J Dev Neurosci. 2012 May ; 30(3): 201–206. doi:10.1016/j.ijdevneu.2011.10.007.


Falls, Brain injury, Mechanism, Age



Date Posted: 25 May 2016

This document has been peer reviewed.