{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T23:01:20Z","timestamp":1765666880906,"version":"3.40.5"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,4,1]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p>The goal was to measure differences in the causes, mechanisms, acute clinical presentations, injuries, and outcomes of children &amp;lt;36 months of age with varying \u201cgreatest depths\u201d of acute cranial injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Children &amp;lt;36 months of age who were hospitalized with acute head trauma were recruited at multiple sites. Clinical and imaging data were collected, and caregivers underwent scripted interviews. Neurodevelopmental evaluations were completed 6 months after injury. Head trauma causes were categorized independently, and subject groups with varying greatest depths of injury were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Fifty-four subjects were enrolled at 9 sites. Twenty-seven subjects underwent follow-up neurodevelopmental assessments 6 months after injury. Greatest depth of visible injury was categorized as scalp, skull, or epidural for 20 subjects, subarachnoid or subdural for 13, cortical for 10, and subcortical for 11. Compared with subjects with more-superficial injuries, subjects with subcortical injuries more frequently had been abused (odds ratio [OR]: 35.6; P &amp;lt; .001), more frequently demonstrated inertial injuries (P &amp;lt; .001), more frequently manifested acute respiratory (OR: 43.9; P &amp;lt; .001) and\/or circulatory (OR: 60.0; P &amp;lt; .001) compromise, acute encephalopathy (OR: 28.5; P = .003), prolonged impairments of consciousness (OR: 8.4; P = .002), interhemispheric subdural hemorrhage (OR: 10.1; P = .019), and bilateral brain hypoxia, ischemia, or swelling (OR: 241.6; P &amp;lt; .001), and had lower Mental Developmental Index (P = .006) and Gross Motor Quotient (P &amp;lt; .001) scores 6 months after injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>For children &amp;lt;3 years of age, head injury depth is a useful indicator of injury causes and mechanisms.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2009-2133","type":"journal-article","created":{"date-parts":[[2010,3,30]],"date-time":"2010-03-30T02:53:47Z","timestamp":1269917627000},"page":"712-720","source":"Crossref","is-referenced-by-count":17,"title":["Head Injury Depth as an Indicator of Causes and Mechanisms"],"prefix":"10.1542","volume":"125","author":[{"given":"Kent P.","family":"Hymel","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Dartmouth Medical School, Children's Hospital at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Stoiko","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Michigan State University School of Medicine, Spectrum Health Hospitals and Helen DeVos Children's Hospital, Grand Rapids, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce E.","family":"Herman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah School of Medicine, Primary Children's Medical Center, Salt Lake City, Utah;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Combs","sequence":"additional","affiliation":[{"name":"Center for Child Protection, Spectrum Health Hospitals and Helen DeVos Children's Hospital, Grand Rapids, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy S.","family":"Harper","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Texas A&M University, Driscoll Children's Hospital, Corpus Christi, Texas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Lowen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Oklahoma College of Medicine, Tulsa, Oklahoma;"},{"name":"Children's Justice Center, Tulsa, Oklahoma;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine P.","family":"Deye","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Inova Fairfax Hospital for Children, Falls Church, Virginia;"},{"name":"Department of Pediatrics, National Children's Medical Center, Washington, DC;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Homa","sequence":"additional","affiliation":[{"name":"Leadership Preventive Medicine Residency Program, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Blackman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, Virginia; and"},{"name":"Department of Pediatrics, Kluge Children's Rehabilitation Center, Charlottesville, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2010,4,1]]},"reference":[{"issue":"3","key":"2021120906025452700_B1","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1542\/peds.93.3.364","article-title":"A nationwide study of the risk of injury associated with day care center attendance","volume":"93","author":"Briss","year":"1994","journal-title":"Pediatrics"},{"issue":"6","key":"2021120906025452700_B2","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1542\/peds.2007-2281","article-title":"Annual risk of death resulting from short falls among young children: less than 1 in 1 million","volume":"121","author":"Chadwick","year":"2008","journal-title":"Pediatrics"},{"issue":"6","key":"2021120906025452700_B3","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1097\/00005373-199312000-00031","article-title":"Likelihood of the death of an infant or young child in a short fall of less than 6 vertical feet","volume":"35","author":"Chadwick","year":"1993","journal-title":"J Trauma"},{"issue":"2","key":"2021120906025452700_B4","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1542\/peds.2015-0119","article-title":"Injuries among preschool children enrolled in day-care centers","volume":"83","author":"Chang","year":"1989","journal-title":"Pediatrics"},{"issue":"2","key":"2021120906025452700_B5","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1542\/peds.90.2.179","article-title":"Head injury in very young children: mechanisms, injury types, and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age","volume":"90","author":"Duhaime","year":"1992","journal-title":"Pediatrics"},{"issue":"4","key":"2021120906025452700_B6","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1542\/peds.60.4.533","article-title":"Injuries resulting when small children fall out of bed","volume":"60","author":"Helfer","year":"1977","journal-title":"Pediatrics"},{"issue":"5","key":"2021120906025452700_B7","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1542\/peds.2006-3111","article-title":"Mechanisms, clinical presentations, injuries, and outcomes from inflicted versus noninflicted head trauma during infancy: results of a prospective, multicentered, comparative study","volume":"119","author":"Hymel","year":"2007","journal-title":"Pediatrics"},{"issue":"3","key":"2021120906025452700_B8","first-page":"292","article-title":"Accidental injuries in children in day-care centers","volume":"141","author":"Landman","year":"1987","journal-title":"Am J Dis Child"},{"issue":"8","key":"2021120906025452700_B9","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1001\/archpedi.1993.02160320028014","article-title":"Injuries to preschool-age children in day-care centers: a retrospective record review","volume":"147","author":"Leland","year":"1993","journal-title":"Am J Dis Child"},{"issue":"1","key":"2021120906025452700_B10","first-page":"125","article-title":"Falling out of bed: a relatively benign occurrence","volume":"92","author":"Lyons","year":"1993","journal-title":"Pediatrics"},{"issue":"2","key":"2021120906025452700_B11","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1097\/01241398-198703000-00014","article-title":"The likelihood of injuries when children fall out of bed","volume":"7","author":"Nimityongskul","year":"1987","journal-title":"J Pediatr Orthop"},{"issue":"1","key":"2021120906025452700_B12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00000433-200103000-00001","article-title":"Fatal pediatric head injuries caused by short-distance falls","volume":"22","author":"Plunkett","year":"2001","journal-title":"Am J Forensic Med Pathol"},{"issue":"3","key":"2021120906025452700_B13","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/00000433-199309000-00005","article-title":"Fatal falls in childhood: how far must children fall to sustain fatal head injury? Report of cases and review of the literature","volume":"14","author":"Reiber","year":"1993","journal-title":"Am J Forensic Med Pathol"},{"issue":"12","key":"2021120906025452700_B14","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1001\/jama.1989.03430120095028","article-title":"The epidemiology of injuries in Atlanta day-care centers","volume":"262","author":"Sacks","year":"1989","journal-title":"JAMA"},{"issue":"1","key":"2021120906025452700_B15","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/00006565-199902000-00002","article-title":"Short vertical falls in infants","volume":"15","author":"Tarantino","year":"1999","journal-title":"Pediatr Emerg Care"},{"issue":"10","key":"2021120906025452700_B16","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1097\/00005373-199110000-00005","article-title":"Injuries in infants and small children resulting from witnessed and corroborated free falls","volume":"31","author":"Williams","year":"1991","journal-title":"J Trauma"},{"issue":"10","key":"2021120906025452700_B17","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/S0145-2134(97)00054-9","article-title":"Restricting the time of injury in fatal inflicted head injuries","volume":"21","author":"Willman","year":"1997","journal-title":"Child Abuse Negl"},{"issue":"6","key":"2021120906025452700_B18","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1159\/000121058","article-title":"Long-term outcome in infants with the shaking-impact syndrome","volume":"24","author":"Duhaime","year":"1996","journal-title":"Pediatr Neurosurg"},{"key":"2021120906025452700_B19","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0079-6123(06)61020-0","article-title":"Traumatic brain injury in infants: the phenomenon of subdural hemorrhage with hemispheric hypodensity (\u201cbig black brain\u201d)","volume":"161","author":"Duhaime","year":"2007","journal-title":"Prog Brain Res"},{"issue":"8","key":"2021120906025452700_B20","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1111\/j.1651-2227.2007.00356.x","article-title":"Traumatic head injury in infants and toddlers","volume":"96","author":"Myhre","year":"2007","journal-title":"Acta Paediatr"},{"issue":"3","key":"2021120906025452700_B21","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1148\/130.3.687","article-title":"Computed tomography of craniocerebral injury in the abused child","volume":"130","author":"Zimmerman","year":"1979","journal-title":"Radiology"},{"issue":"7","key":"2021120906025452700_B22","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1093\/brain\/124.7.1290","article-title":"Neuropathology of inflicted head injury in children, part I: patterns of brain damage","volume":"124","author":"Geddes","year":"2001","journal-title":"Brain"},{"issue":"7","key":"2021120906025452700_B23","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1093\/brain\/124.7.1299","article-title":"Neuropathology of inflicted head injury in children, part II: microscopic brain injury in infants","volume":"124","author":"Geddes","year":"2001","journal-title":"Brain"},{"issue":"3","key":"2021120906025452700_B24","doi-asserted-by":"crossref","first-page":"232","DOI":"10.3171\/2008.11.PEDS0835","article-title":"Neck injuries in young pediatric homicide victims","volume":"3","author":"Brennan","year":"2009","journal-title":"J Neurosurg Pediatr"},{"issue":"4","key":"2021120906025452700_B25","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1093\/brain\/97.1.633","article-title":"Cerebral concussion and traumatic unconsciousness: correlation of experimental and clinical observations of blunt head injuries","volume":"97","author":"Ommaya","year":"1974","journal-title":"Brain"},{"issue":"3","key":"2021120906025452700_B26","first-page":"432","article-title":"Magnetic resonance imaging in relation to functional outcome of pediatric closed head injury: a test of the Ommaya-Gennarelli model","volume":"40","author":"Levin","year":"1997","journal-title":"Neurosurgery"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/125\/4\/712\/895913\/zpe00410000712.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/125\/4\/712\/895913\/zpe00410000712.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T11:42:01Z","timestamp":1711366921000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/125\/4\/712\/73147\/Head-Injury-Depth-as-an-Indicator-of-Causes-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,4,1]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2010,4,1]]},"published-print":{"date-parts":[[2010,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2009-2133","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2010,4,1]]}}}