Infants with head injuries-do all need hospital admission?

Abstract

Head injury in a young infant is a common presentation in paediatric emergency departments and clinicians often admit these young infants (less than 12months of age) for further neuro-observation due to lack of strong evidence base and standard recommendations about the management of such a young patient with head injury. We performed this retrospective observational study to find out whether inpatient admission is really necessary in those infants who present with minor head injury to the paediatric emergency departments. Electronic patient record system and handwritten patient records were retrospectively accessed of the infants admitted with minor head injury to the paediatric ward of the Midland Regional Hospital, Mullingar over a period of the previous 5years. A total of 256 infants less than 12months of age met the criteria of minor head injury at admission and none of them showed any clinical indicators indicating serious intracranial injury whilst under observation in the paediatric ward. They all remained well and were discharged later after a period of observation. Barring few clinical circumstances which put these young infants at increased risk of clinically important traumatic brain injury, a vast majority of minor head injury in infants can be safely observed at home with reliable caretakers and proper discharge instructions.