ArticleBMC emergency medicine2025
Outcomes and risk factors of traumatic brain injury in infants under 3 months with minor head trauma: a retrospective study from a tertiary care center in Riyadh, Saudi Arabia.
Article in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDiagnosing traumatic brain injury (TBI) after minor head trauma (MHT) in infants < 3 months is challenging; the applicability of PECARN is uncertain in this age group. To describe outcomes and risk factors for CT-confirmed (radiologic) TBI and clinically important TBI (ciTBI) in infants < 3 months with MHT.
methodsRetrospective cohort at a tertiary pediatric ED (Riyadh), Jan 2021–May 2025. Infants < 3 months presenting ≤ 24 h after MHT were included; suspected NAT was excluded. Primary outcome was radiologic TBI; secondary outcome was ciTBI. Because of sparse data, associations were estimated with exact (Fisher-based) univariable ORs in the CT-imaged subset.
resultsOf 77 infants, 23 (29.9%) underwent head CT; radiologic TBI occurred in 18/23 (78.3%; 95% CI 56.3–92.5%), predominantly isolated skull fractures, while ciTBI occurred in 2/77 (2.6%). Non-frontal scalp hematoma was strongly associated with radiologic TBI (OR 50.00; 95% CI 2.12–1178.94; p = 0.0017). Fall vs. not-fall was associated (OR 24.00; 95% CI 0.86–671.39; p = 0.040); fall distance ≥ 0.9 m was not significant (OR 2.33; p = 0.576). Most non-imaged infants met PECARN low-risk criteria.
conclusionsIn infants < 3 months with MHT, non-frontal scalp hematoma is a high-yield marker for radiologic TBI, whereas ciTBI is uncommon. Findings support targeted imaging (when high-risk features cluster) and observation with safety-netting for otherwise low-risk infants, balancing potential benefit against radiation risk.
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