What's up guys? Today we're going to be talking about pediatric head injuries. We're going to talk about how to classify these injuries, how to do a good physical exam, what imaging studies do we need to order, how do we manage these patients, and finally how do we disposition these patients. However, to understand how to manage head injuries, you must first be aware that head injuries exist on a spectrum

and can be broken down to three different categories.

You have minor head trauma,

mio-traumatic brain injuries,

and clinically important traumatic brain injuries.

Minor head trauma can be defined in a child younger than two years of age, and any child with a history

or physical signs of blunt trauma to the scalp, skull, or brain, who are alert or awake

to voice or light touch.

Now play close attention because this definition only applies to children less than two.

This is because clinical assessment of these patients are often more difficult.

Infants with intracranial injuries are frequently asymptomatic,

and skull fractures are clinically important traumatic brain injuries may occur despite only minor trauma,

and inflicted injuries occur more frequently.

Minor head trauma and children two years and older can be defined by a gloss-cal coma scale of 14 or 15 at the initial examination, no abnormal or focal findings on

neuroexam. And no evidence of a skull fracture such as a palpable skull defect,

a hemmy-timpanum, indicating a baselar skull fracture or a CSF leakage from the ears or nose or a periocular or

posterior orricular hematomas, more commonly referred to as raccoon eyes or battle signs.

Myotramatic brain injuries are generally going to be associated

with symptoms such as brief loss of consciousness, disorientation, vomiting, or signs

and symptoms consistent with concussions.

And these patients will typically have a glosscal coma scale of 13 to 15 measured

approximately 30 minutes after the injury.

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