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Neonatal head injuries: A prospective Paediatric Research in Emergency Departments International Collaborative cohort study

Eapen, Nitaa; Borland, Meredith L.; Phillips, Natalie; Kochar, Amit; Dalton, Sarah; Cheek, John A.; Gilhotra, Yuri; Neutze, Jocelyn; Lyttle, Mark D.; Donath, Susan; Crowe, Louise; Dalziel, Stuart R.; Oakley, Ed; Williams, Amanda; Hearps, Stephen; Bressan, Silvia; Babl, Franz E.

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Authors

Nitaa Eapen

Meredith L. Borland

Natalie Phillips

Amit Kochar

Sarah Dalton

John A. Cheek

Yuri Gilhotra

Jocelyn Neutze

Susan Donath

Louise Crowe

Stuart R. Dalziel

Ed Oakley

Amanda Williams

Stephen Hearps

Silvia Bressan

Franz E. Babl



Abstract

Aim
To characterise the causes, clinical characteristics and short‐term outcomes of neonates who presented to paediatric emergency departments with a head injury.

Methods
Secondary analysis of a prospective data set of paediatric head injuries at 10 emergency departments in Australia and New Zealand. Patients without neuroimaging were followed up by telephone call. We extracted epidemiological information, clinical findings and outcomes in neonates (≤28 days).

Results
Of 20 137 children with head injuries, 93 (0.5%) occurred in neonates. These were mostly fall‐related (75.2%), commonly from a care giver's arms, or due to being accidentally struck by a person/object (20.4%). There were three cases of non‐accidental head injuries (3.2%). Most neonates were asymptomatic (67.7%) and many had no findings on examination (47.3%). Most neonates had a Glasgow Coma Scale 15 (89.2%) or 14 (7.5%). A total of 15.1% presented with vomiting and 5.4% were abnormally drowsy. None had experienced a loss of consciousness. The most common findings on examination were scalp haematoma (28.0%) and possible palpable skull fracture (6.5%); 8.6% underwent computed tomography brain scan and 4.3% received an ultrasound. Five of eight computed tomography scan (5.4% of neonates overall) showed traumatic brain injury and two of four (2.2% overall) had traumatic brain injury on ultrasound. Thirty‐seven percent were admitted, one patient was intubated and none had neurosurgery or died.

Conclusions
Neonatal head injuries are rare with a mostly benign short‐term outcome and are appropriate for observation. However, non‐accidental injuries need to be considered.

Citation

Eapen, N., Borland, M. L., Phillips, N., Kochar, A., Dalton, S., Cheek, J. A., …Babl, F. E. (2020). Neonatal head injuries: A prospective Paediatric Research in Emergency Departments International Collaborative cohort study. Journal of Paediatrics and Child Health, 56(5), 764-769. https://doi.org/10.1111/jpc.14736

Journal Article Type Article
Acceptance Date Dec 2, 2019
Online Publication Date Dec 23, 2019
Publication Date May 1, 2020
Deposit Date Jul 21, 2020
Publicly Available Date Mar 29, 2024
Journal Journal of Paediatrics and Child Health
Print ISSN 1034-4810
Electronic ISSN 1440-1754
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 56
Issue 5
Pages 764-769
DOI https://doi.org/10.1111/jpc.14736
Keywords Pediatrics, Perinatology, and Child Health
Public URL https://uwe-repository.worktribe.com/output/6137259

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