Contributing Editor's Note: The immature brain, at a time when it is rapidly acquiring new information, responds differently from the adult brain when subjected to an equivalent amount of mechanical force. Head injury in infants younger than 2 years of age is second only to road traffic accidents as a cause of death in childhood. Measurable deficits occur even after mild to moderate head injury. Head injury in infancy and childhood causes impaired cognition, motor impairments, disruption of attention and information processing, and psychiatric disturbances, even death. Still there is relatively little information about the structural basis of the clinical deficits.
Excerpt: The current belief is that head-injured infants are likely to have undergone shaking followed by sudden inertial injury from impact. "Why is it that there are continuing uncertainties about the nature, the distribution and the pathologies in accidental and non-accidental injury in infants and children?" To answer this, the authors have undertaken a meticulous clinicopathological correlation in 53 cases and data were analyzed by median age at head injury, statistically significant patterns of age-related damage emerged. The most important finding was "the predominant neurohistological abnormality in the cases of non-accidental injury in infants was due to hypoxia and not diffuse axonal injury".