Skull fractures following head trauma in the first year of life: epidemiology, mechanisms and outcomes
DOI:
https://doi.org/10.46900/apn.v8i3.395Keywords:
infant head trauma, skull fracture, traumatic brain injury, Abusive head trauma, preventionAbstract
Introduction: Head trauma during infancy represents a distinctive clinical entity due to the rapid developmental changes in the first year of life. Skull fractures are a clinically relevant marker of traumatic head injury in infants and frequently prompt hospital admission and specialist evaluation. Understanding mechanisms and clinical characteristics is essential for improving diagnostic assessment and prevention strategies.
Materials and Methods: This retrospective study included infants <12 months admitted to our Institution between 2021 and 2025, diagnosed with a skull fracture. Birth-related trauma was excluded. Demographic, radiological, and clinical data were analyzed. Trauma mechanisms were classified as accidental, non-accidental, medical condition–related, or other. Accidental mechanisms were further subdivided according to the circumstances of the fall.
Results: A total of 156 infants were included. Accidental trauma accounted for 89.7% of cases; 4.5% were classified as non-accidental trauma. The fractures were mostly parietal (72.4%); intracranial hemorrhage occurred in 43.6%. Seventeen patients (10.9%) required neurosurgical intervention; 24 (15.4%) required intensive care admission. Fundoscopic abnormalities were identified in six infants, predominantly in cases of non-accidental trauma. Analysis by developmental age groups demonstrated clear age-related patterns of injury mechanisms, with caregiver-related falls predominating during the first months of life and supervision-related injuries increasing with the onset of mobility.
Conclusions: Head trauma resulting in skull fractures during the first year of life demonstrates distinct developmental patterns of injury. These findings highlight the importance of developmental context in clinical assessment and suggest that many injuries may be preventable through targeted caregiver education and improved domestic safety measures.
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Copyright (c) 2026 Alessandra Musarra, Pierre Petitet, Camilla de Laurentis, Audrey Mittelman, Pierre-Aurélien Beuriat, Alexandru Szathmari, Matthieu Vinchon, Nicolas Pianton, Yves Gillet, Federico Di Rocco
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