Minor impacts to the head are extremely common for children and adolescents, but only a small percentage of these will result in skull injuries or intracranial injuries, and even fewer will result in clinically significant long term effects. Nevertheless, trauma is the number one cause of mortality in children over 1 year of age, with head trauma involved in about 80% of those deaths.  It is crucially important to be able to recognize which head traumas are minor, and which can result in significant morbidity or mortality.

The following is a series of 3 cases which deal with the acute management of head traumas in pediatric populations. These cases were developed by Mark McKinney and Dr. Mel Lewis. Mark is a medical student at the University of Alberta. Dr. Lewis is an Associate Professor in the Department of Pediatrics, and Associate Dean of Learner Advocacy & Wellness at the University of Alberta.

Learning Objectives:

• Definition, related anatomy, and pathophysiology of some common head injury pathologies
• Improved understanding of common head injury pathologies including skull fractures, basilar skull fractures, and concussions.
• Basic understanding of the importance of the mechanism of injury and how it differs from underlying cause of the injury
• How to assess for and recognize intracranial injury
• Understanding of pediatric Glasgow Coma Scale and how it differs from adult Glasgow Coma Scale
• Goal of acute management of head injury – preventing secondary injury vs. primary injury
• Indications for various modalities to investigate neurological structure and function
• Indications for neurosurgery consult / intervention
• Indications for safe discharge