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Multicenter Study
. 2025 Jan;114(1):156-163.
doi: 10.1111/apa.17420. Epub 2024 Sep 23.

Management of neonatal head injuries: A retrospective cohort study

Niccolò Parri  1 , Martina Giacalone  1 , Marco Greco  1 , Arianna Aceti  2 , Ersilia Lucenteforte  3 , Iuri Corsini  4 ; NeonATal Injury preVention rEsearch (NATIVE) group
Collaborators, Affiliations
Multicenter Study

Management of neonatal head injuries: A retrospective cohort study

Niccolò Parri et al. Acta Paediatr. 2025 Jan.

Abstract

Aim: The aim of this study is to describe circumstances, management and short-term outcomes of neonatal head trauma, and adherence to the Paediatric Emergency Care Applied Research Network (PECARN) head trauma prediction rule for children under 2 years.

Methods: Multicentre retrospective cohort study of neonates (<29 days) with head trauma across 25 emergency departments (ED) from January 2017 to June 2021.

Results: A total of 492 neonates (median age 17 days, range 0-28 days) with non-trivial head trauma were enrolled. Falls were the most common injury mechanism (375/492, 76.2%). Imaging was performed in 150/492 (30.5%) neonates. Clinically important traumatic brain injury (ciTBI), defined as death, neurosurgery, prolonged intubation, or extended hospitalisation from injury, occurred in 7/492 (1.4%) cases. Notably, 286/492 (58.1%) neonates were managed by short-term observation (<48 h), and 126/492 (25.6%) were admitted. Among high-risk neonates per PECARN criteria, 17/21 (80.9%) did not undergo recommended head CT scans but were observed within ED short observation units or underwent alternative imaging, with no ciTBI diagnoses among those discharged without CT.

Conclusion: Severe neonatal head injuries are rare, and most neonatal head injuries have a favourable outcome, making observation a suitable approach, while remaining vigilant for signs of non-accidental injuries.

Keywords: head computed tomography; head trauma; neonate; traumatic brain injury.

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References

REFERENCES

    1. Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically‐important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;374:1160‐1170.
    1. Miglioretti DL, Johnson E, Williams A, et al. The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr. 2013;167:700‐707.
    1. Da Dalt L, Parri N, Amigoni A, et al. Italian guidelines on the assessment and management of pediatric head injury in the emergency department. Ital J Pediatr. 2018;44:7.
    1. Eapen N, Borland ML, Phillips N, et al. Neonatal head injuries: a prospective Paediatric research in emergency departments international collaborative cohort study. J Paediatr Child Health. 2020;56:764‐769.
    1. Hughes Driscoll CA, Pereira N, Lichenstein R. In‐hospital neonatal falls: an unintended consequence of efforts to improve breastfeeding. Pediatrics. 2019;143:e20182488.

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