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Infants and preschoolers sustaining traumatic brain injury represent a distinct group in terms of injury characteristics, medical management, and outcome. Although the majority of traumatic brain injuries occurring during early childhood are mild, severe injuries are associated with high rates of mortality and morbidity. The less favorable neurobehavioral outcome frequently identified in infants and preschoolers in relation to outcome in other pediatric age groups is likely due to the high rate of inflicted injury in young children. Inflicted injury often subjects the brain to rotational acceleration-deceleration forces that produce diffuse damage, leading to a high rate of death or persistent disability.