The potential and limitations of utilising head impact injury models to assess the likelihood of significant head injury in infants after a fall

The use of engineering principles in assessing head injury scenarios is of increasing significance in investigations into suspected child abuse. A fall scenario is often given as the history for a head injury to an infant. This paper addresses the basic engineering principles and factors to be considered when calculating the severity of a head impact after free-fall. The application of head injury models (HIMs) to ascertain the forces involved in childhood head injuries from impact is also discussed. Previous studies including Duhaime et al. [J. Neurosurg. 66 (1987) 409] and Nokes et al. [Forensic Sci. Int. 79 (1995) 85] have utilised HIMs for this purpose: this paper reviews those models most widely documented. The HIM currently considered the ‘state-of-the-art’ is the head injury criterion (HIC) and it is suggested that this model should be utilised for assessing head impact injury in child abuse cases where appropriate.