{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:10:12Z","timestamp":1792120212859,"version":"4.4.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>There are only 3 small case series in the literature that report on the management of in-hospital newborn falls (NFs), and recommendations are unclear. The authors performed a retrospective review to determine outcome and differences in management and to understand why management of NFs varies at their institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>All NFs occurring within the authors\u2019 institution over a 3.5-year period were reviewed. Post-fall management and outcomes of each incident were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>There were 24 NFs out of 40,349 deliveries (5.9 NFs\/10,000 deliveries). The mechanism of injury was nearly identical in 22 of 24 falls (the newborn fell to the floor from a parent in a bed or chair), and physical examination findings were normal or benign in all cases. Unexplained management variation based solely on clinician preference was noted, including observation only (in 13 cases), skull radiograph (in 7), head CT scan (in 6), bone survey (in 4), and head ultrasound examination (in 1), with some babies having more than 1 study. Two babies had nondepressed linear parietal fractures diagnosed by skull radiograph, and 2 babies had small subdural hemorrhages diagnosed by head CT scan. All 24 babies had normal findings on examination at discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>There is a high incidence of nondepressed linear parietal skull fractures associated with NFs. However, since associated intracranial injury is uncommon, imaging studies may not be routinely performed. Neonatal intensive care unit admission, head CT, and neurosurgical evaluation are reserved for the rare baby with abnormal physical examination or neurological findings.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.3.peds16651","type":"journal-article","created":{"date-parts":[[2017,5,19]],"date-time":"2017-05-19T13:57:21Z","timestamp":1495202241000},"page":"176-182","source":"Crossref","is-referenced-by-count":23,"title":["Variation in management of in-hospital newborn falls: a single-center experience"],"prefix":"10.3171","volume":"20","author":[{"given":"Doron J.","family":"Kahn","sequence":"first","affiliation":[{"name":"Divisions of Neonatology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Pediatric Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean A.","family":"Hertzler","sequence":"additional","affiliation":[{"name":"Neurosurgery, Joe DiMaggio Children\u2019s Hospital, Hollywood, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","article-title":"Choosing Wisely: Five Things Physicians and Patients Should Question","year":"2015","unstructured":"American Academy of Pediatrics: Choosing Wisely: Five Things Physicians and Patients Should Question. Elk Grove, IL: American Academy of Pediatrics, 2015 (http:\/\/www.choosingwisely.org\/wp-content\/uploads\/2015\/02\/AAP-Choosing-Wisely-List.pdf) [Accessed April 18, 2017]"},{"key":"b2","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1542\/peds.104.6.1407","article-title":"The management of minor closed head injury in children","volume":"104","author":"Bergman DA","year":"1999","unstructured":"Bergman DA, Baltz RD, Cooley JR, Coombs JB, Goldberg MJ, Homer CJ, : The management of minor closed head injury in children. Pediatrics 104:1407\u20131415, 199910.1542\/peds.104.6.1407"},{"issue":"228\u2013231","key":"b3","series-title":"Pediatr Radiol","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1007\/s00247-002-0671-1","article-title":"Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative","volume":"32","author":"Brenner DJ","year":"2002","unstructured":"Brenner DJ: Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol 32:228\u2013231, 242\u2013244, 200210.1007\/s00247-002-0671-1"},{"key":"b4","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"2277","DOI":"10.1056\/NEJMra072149","article-title":"Computed tomography\u2014an increasing source of radiation exposure","volume":"357","author":"Brenner DJ","year":"2007","unstructured":"Brenner DJ, Hall EJ: Computed tomography\u2014an increasing source of radiation exposure. N Engl J Med 357:2277\u20132284, 20071804603110.1056\/NEJMra072149"},{"key":"b5","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1542\/peds.104.4.861","article-title":"Clinical indicators of intracranial injury in head-injured infants","volume":"104","author":"Greenes DS","year":"1999","unstructured":"Greenes DS, Schutzman SA: Clinical indicators of intracranial injury in head-injured infants. Pediatrics 104:861\u2013867, 19991050622610.1542\/peds.104.4.861"},{"key":"b6","series-title":"Pediatr Emerg Care","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1097\/00006565-200104000-00002","article-title":"Clinical significance of scalp abnormalities in asymptomatic head-injured infants","volume":"17","author":"Greenes DS","year":"2001","unstructured":"Greenes DS, Schutzman SA: Clinical significance of scalp abnormalities in asymptomatic head-injured infants. Pediatr Emerg Care 17:88\u201392, 20011133410010.1097\/00006565-200104000-00002"},{"key":"b7","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1016\/S0196-0644(98)70067-8","article-title":"Occult intracranial injury in infants","volume":"32","author":"Greenes DS","year":"1998","unstructured":"Greenes DS, Schutzman SA: Occult intracranial injury in infants. Ann Emerg Med 32:680\u2013686, 199810.1016\/S0196-0644(98)70067-89832664"},{"key":"b8","series-title":"Jt Comm J Qual Patient Saf","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/S1553-7250(10)36049-1","article-title":"Addressing in-hospital \u201cfalls\u201d of newborn infants","volume":"36","author":"Helsley L","year":"2010","unstructured":"Helsley L, McDonald JV, Stewart VT: Addressing in-hospital \u201cfalls\u201d of newborn infants. Jt Comm J Qual Patient Saf 36:327\u2013333, 201010.1016\/S1553-7250(10)36049-121226386"},{"key":"b9","series-title":"AJR Am J Roentgenol","doi-asserted-by":"publisher","first-page":"540","DOI":"10.2214\/AJR.06.0101","article-title":"Patient radiation doses from adult and pediatric CT","volume":"188","author":"Huda W","year":"2007","unstructured":"Huda W, Vance A: Patient radiation doses from adult and pediatric CT. AJR Am J Roentgenol 188:540\u2013546, 20071724226610.2214\/AJR.06.0101"},{"key":"b10","series-title":"Arch Dis Child","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1136\/archdischild-2014-306803","article-title":"Biomechanical characteristics of head injuries from falls in children younger than 48 months","volume":"101","author":"Hughes J","year":"2016","unstructured":"Hughes J, Maguire S, Jones M, Theobald P, Kemp A: Biomechanical characteristics of head injuries from falls in children younger than 48 months. Arch Dis Child 101:310\u2013315, 201610.1136\/archdischild-2014-30680326384509"},{"key":"b11","series-title":"Am J Case Rep","doi-asserted-by":"publisher","first-page":"50","DOI":"10.12659\/AJCR.892506","article-title":"Life-threatening neonatal epidural hematoma caused by precipitous vaginal delivery","volume":"16","author":"Josephsen JB","year":"2015","unstructured":"Josephsen JB, Kemp J, Elbabaa SK, Al-Hosni M: Life-threatening neonatal epidural hematoma caused by precipitous vaginal delivery. Am J Case Rep 16:50\u201352, 201510.12659\/AJCR.89250625633886"},{"key":"b12","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1016\/S0140-6736(09)61558-0","article-title":"Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study","volume":"374","author":"Kuppermann N","year":"2009","unstructured":"Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, : Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374:1160\u20131170, 200910.1016\/S0140-6736(09)61558-019758692"},{"key":"b13","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1016\/S0140-6736(96)09356-7","article-title":"Predictive value of skull radiography for intracranial injury in children with blunt head injury","volume":"349","author":"Lloyd DA","year":"1997","unstructured":"Lloyd DA, Carty H, Patterson M, Butcher CK, Roe D: Predictive value of skull radiography for intracranial injury in children with blunt head injury. Lancet 349:821\u2013824, 199710.1016\/S0140-6736(96)09356-79121256"},{"key":"b14","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1148\/radiol.2422060133","article-title":"Intracranial hemorrhage in asymptomatic neonates: prevalence on MR images and relationship to obstetric and neonatal risk factors","volume":"242","author":"Looney CB","year":"2007","unstructured":"Looney CB, Smith JK, Merck LH, Wolfe HM, Chescheir NC, Hamer RM, : Intracranial hemorrhage in asymptomatic neonates: prevalence on MR images and relationship to obstetric and neonatal risk factors. Radiology 242:535\u2013541, 200710.1148\/radiol.242206013317179400"},{"key":"b15","series-title":"Pediatrics","first-page":"e277","article-title":"In-hospital falls of newborn infants: data from a multihospital health care system","volume":"122","author":"Monson SA","year":"2008","unstructured":"Monson SA, Henry E, Lambert DK, Schmutz N, Christensen RD: In-hospital falls of newborn infants: data from a multihospital health care system. Pediatrics 122:e277\u2013e280, 2008"},{"key":"b16","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/S0140-6736(12)60815-0","article-title":"Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study","volume":"380","author":"Pearce MS","year":"2012","unstructured":"Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, : Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380:499\u2013505, 20122268186010.1016\/S0140-6736(12)60815-0"},{"key":"b17","series-title":"Pediatrics","first-page":"e851","article-title":"Isolated linear skull fractures in children with blunt head trauma","volume":"135","author":"Powell EC","year":"2015","unstructured":"Powell EC, Atabaki SM, Wootton-Gorges S, Wisner D, Mahajan P, Glass T, : Isolated linear skull fractures in children with blunt head trauma. Pediatrics 135:e851\u2013e857, 2015"},{"key":"b18","series-title":"Pediatrics","first-page":"1","article-title":"Diagnostic testing for acute head injury in children: when are head computed tomography and skull radiographs indicated?","volume":"99","author":"Quale KS","year":"1997","unstructured":"Quale KS, Jaffe DM, Kuppermann N, Kaufman BA, Lee BC, Park TS, : Diagnostic testing for acute head injury in children: when are head computed tomography and skull radiographs indicated? Pediatrics 99:1\u20138, 1997"},{"key":"b19","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.3174\/ajnr.A1004","article-title":"Prevalence and evolution of intracranial hemorrhage in asymptomatic term infants","volume":"29","author":"Rooks VJ","year":"2008","unstructured":"Rooks VJ, Eaton JP, Ruess L, Petermann GW, Keck-Wherley J, Pedersen RC: Prevalence and evolution of intracranial hemorrhage in asymptomatic term infants. AJNR Am J Neuroradiol 29:1082\u20131089, 200810.3174\/ajnr.A100418388219"},{"key":"b20","series-title":"Arch Dis Child Fetal Neonatal Ed","first-page":"F144","article-title":"Head trauma outcomes of verifiable falls in newborn babies","volume":"95","author":"Ruddick C","year":"2010","unstructured":"Ruddick C, Platt MW, Lazaro C: Head trauma outcomes of verifiable falls in newborn babies. Arch Dis Child Fetal Neonatal Ed 95:F144\u2013F145, 2010"},{"key":"b21","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1542\/peds.107.5.983","article-title":"Evaluation and management of children younger than two years old with apparently minor head trauma: proposed guidelines","volume":"107","author":"Schutzman SA","year":"2001","unstructured":"Schutzman SA, Barnes P, Duhaime AC, Greenes D, Homer C, Jaffe D, : Evaluation and management of children younger than two years old with apparently minor head trauma: proposed guidelines. Pediatrics 107:983\u2013993, 20011133167510.1542\/peds.107.5.983"},{"key":"b22","series-title":"Ann Emerg Med","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1067\/mem.2001.109440","article-title":"Pediatric minor head trauma","volume":"37","author":"Schutzman SA","year":"2001","unstructured":"Schutzman SA, Greenes DS: Pediatric minor head trauma. Ann Emerg Med 37:65\u201374, 200110.1067\/mem.2001.10944011145776"},{"key":"b23","series-title":"Pa Patient Saf Advis","first-page":"102","article-title":"Balancing family bonding with newborn safety","volume":"11","author":"Wallace SC","year":"2014","unstructured":"Wallace SC: Balancing family bonding with newborn safety. Pa Patient Saf Advis 11:102\u2013108, 2014"},{"key":"b24","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1016\/S0140-6736(04)15730-9","article-title":"Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors","volume":"363","author":"Whitby EH","year":"2004","unstructured":"Whitby EH, Griffiths PD, Rutter S, Smith MF, Sprigg A, Ohadike P, : Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors. Lancet 363:846\u2013851, 20041503102810.1016\/S0140-6736(04)15730-9"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/20\/2\/article-p176.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/20\/2\/article-p176.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/20\/2\/article-p176.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T13:54:34Z","timestamp":1681566874000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/20\/2\/article-p176.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":24,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2017.3.peds16651","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}