Abstract
Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0–3 YO population. In this study, head CT scans from fifty-six 0–3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.
Highlights
The head is one of the most frequently injured body regions for children [1] and head injury is the leading cause of pediatric fatality and disability in the United States [2,3,4]
Correct for gantry tilt of the CT scans: Pediatric head geometry may be distorted when the gantry of the CT scanner is tilted in performing the scans, gantry tilt correction was first conducted for all the CT scans
In order to extend the age ranges with more subjects and better represent the morphological variations for pediatric skulls, in the present study, an improved statistical model of skull geometry was developed based on landmark data extracted from 56 head CT scans that is valid for a larger range of ages (0–3 years old (YO)) and that better considers the effects of variations in head size/shape, suture width, and skull thickness
Summary
The head is one of the most frequently injured body regions for children [1] and head injury is the leading cause of pediatric fatality and disability in the United States [2,3,4]. The geometric variation of the suture, fontanel ossification, and continual bone development with child growth translate into significant differences in skull stiffness across infants and young children of different ages. The head of an infant or a young child is proportionately larger than that of an adult [5]. Head shape differs between infants and adults, such that the infant skull has greater frontal and parietal prominences, making the face tuck below the brain cage. The fibrous tissues in sutures and fontanels allow the cranium to adapt to the fast growth of the brain [7] and they gradually calcify and close until 2–3 years of age [8]. The cranium becomes a three-layered sandwich structure [9, 10]
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