A new study suggests that blunt head injuries caused by common household objects, especially fashion hair accessories, carry the potential for significant morbidity and mortality in toddlers.
"Children younger than age 2 are at particularly high risk for neurological injury because the skull is not fully ossified and small forces may lead to penetration of the skull and dura," says Dr. Richard C. E. Anderson, one of the authors of the study published in the Journal of Neurosurgery.
The study suggests that the complications of such injuries can be severe, including skull fracture, subdural and epidural hematoma, pneumocephalus, cerebral hemorrhage, infection, seizure, focal neurological deficits, and vascular complications.
"Hair beads are radiolucent and thus are difficult to differentiate on radiologic scans from the adjacent soft tissue - the air-filled hollow core may be mistaken for benign air that became entrapped at the time of injury. Fashion hair accessories present a hidden and often overlooked health risk in children who have suffered blunt head trauma, significant enough to cause skull fractures and complicate diagnosis and treatment," says Dr. Anderson.
"The absence of an obvious foreign body on physical examination in one of these two cases, demonstrates the importance of considering fashion hair accessories in the differential diagnosis when children present with head injury following blunt trauma," he adds.
The authors have substantiated their observations with two cases - one of a four-year-old girl who had struck her head on the wooden leg of a bunk bed and then onto the carpeted floor after falling to the floor from a height of about four feet, and the second of a 2 1/2-year-old girl who fell from a bunk bed.
The older girl in the first case was found to have a 2.5-cm right parietal scalp laceration, moderate bleeding, and an underlying hematoma, even though there was no loss of consciousness, vomiting, or seizure activity.
In the second case, though there was no loss of consciousness, nausea, vomiting, or seizure activity, the tiny tot was found to have a 1.5-cm plastic hair bead protruding from the scalp laceration in the frontal midline.
Kids in both cases were save by administering them appropriate treatments.