Infants with intracranial injuries may have limited neurologic findings and appear asymptomatic Clinical assessment of infants may be challenging Index of suspicion for nonaccidental trauma should be low Goal of Treatment The primary goal in the evaluation of any patient who has sustained a blunt head injury is to determine the severity of the injury and identify ciTBI As with all trauma evaluations, the initial goal of treatment is immediate stabilization Current Evidence Neurotrauma is one of the most common reasons for ED evaluation with more than 800,000 annual visits by children ED visits for younger children up to years of age have increased significantly in the past several years Common mechanisms of injury include falls, being unintentionally struck by or against an object, motor vehicle collisions either as a passenger or pedestrian struck by, bicycle accidents, sportsrelated, assaults, and nonaccidental trauma A detailed description of anatomy, pathophysiology, and causes of increased intracranial pressure (ICP) is included in Chapter 41 Injury: Head Briefly, the spectrum of traumatic brain injury (TBI) patterns range from minor head injury, concussion, skull fracture, pneumocephalus, intracranial hematoma, cerebral edema, diffuse axonal injury (DAI), cerebral herniation to death Cerebral hematomas may be extra-axial, occurring in the epidural or subdural space or intra-axial, occurring within the parenchyma of the brain Most recent studies have separated intracranial injury from ciTBI The definition of ciTBI includes the presence of a depressed skull fracture necessitating surgical elevation, neurosurgical intervention including, but not limited to, invasive ICP monitoring, ventriculostomy, hematoma evacuation and/or decompressive craniectomy, endotracheal intubation for more than 24 hours, hospital admission for 48 hours or more, and death Utilizing this definition, the overall incidence of ciTBI ranges from 0.02% to 4.4%