Children and television tipovers: a significant and preventable cause of long-term neurological deficits

Abstract

Object: Television tipover has recently been recognized as a significant cause of injury in children, and head injury accounts for most of the associated deaths. The authors reviewed their experience with children who sustained head injury from falling televisions.

Methods: Children admitted with the diagnosis of head injury related to falling televisions since 1992 were identified from the authors' trauma database, and a retrospective review of the medical records was performed. Eighteen patients were identified: 13 boys and five girls whose ages ranged from 12 months to 10 years (mean 44 months). The admission Glasgow Coma Scale (GCS) score was 15 in 10 patients. Only three patients had a GCS score of 8 or less (one patient had a score of 4). Neurological examinations were normal in 10 patients; three had cranial nerve deficits and three had otorrhea, otorrhagia, or hemotympanum. Radiological abnormalities included 16 skull fractures, three epidural hematomas, three small subdural hematomas, one intracranial hemorrhage, and three venous obstructions of the transverse-sigmoid sinus. The mean hospital stay was 8.9 days (range 2-39 days). Follow up at 0.2 to 68 months (mean 13.4 months) revealed severe neurological deficits in one patient and cranial nerve deficits of cranial nerves six, seven, or eight in six patients.

Conclusions: Falling televisions result in significant head injuries in children, with substantial short- and long-term sequelae. This injury is easily preventable through simple measures taken by both the manufacturers and caregivers.