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Postraumatic intracranial hematomas in infancy. a 16-year experience
E J Herrera1, J C Viano, I L Aznar
1Department of Surgery, Hospital Infantil Municipal de Córdoba, Republic of Argentina. pediatria@mensajes.com
Insights
This study analyzed pediatric post-traumatic intracranial hematomas, finding higher incidence in boys and identifying falls and vehicle accidents as primary causes. Morbidity and mortality rates were 9.7% and 17.7% respectively.
Area of Science:
- Pediatric Neurosurgery
- Trauma Surgery
- Epidemiology
Background:
- Post-traumatic intracranial hematomas (ICH) in children present unique epidemiological and clinical challenges.
- Understanding these aspects is crucial for effective management and prevention strategies in pediatric head injuries.
Purpose of the Study:
- To investigate the epidemiological characteristics of pediatric post-traumatic intracranial hematomas.
- To analyze the causes, clinical presentations, and outcomes of these injuries in children.
Main Methods:
- Retrospective descriptive analysis of 113 pediatric patients with post-traumatic ICH requiring surgery.
- Data collected included age, sex, injury mechanism, clinical signs, diagnosis, and outcomes (morbidity, mortality).
Main Results:
- Higher incidence observed in boys (73.5%) with a mean age of 6 years 5 months.
- Falls (36.3%) and vehicle accidents (33.6%) were the leading causes of craniocerebral trauma.
- Extradural hematomas (66.4%) were most common, with morbidity at 9.7% and mortality at 17.7%.
Conclusions:
- Pediatric post-traumatic ICH disproportionately affects boys, with falls and vehicle accidents being significant injury mechanisms.
- Prompt clinical presentation and timely surgical intervention are critical, though significant morbidity and mortality persist.
Objects:
The objective of this study is to analyze some of the epidemiological aspects in patients with post-traumatic intracranial hematomas (post-traumatic ICH) in infancy. These patients were treated at the Hospital Infantil Municipal de Córdoba, Argentina, between April 1980 and April 1996.
Methods:
A retrospective descriptive analysis was conducted on the 113 case histories of children with post-traumatic ICH, all of whom required surgical intervention during this period. Relevant information such as age, sex, mechanism of injury causing craniocerebral trauma (CCT), and data on clinical presentation on admission, diagnosis, morbidity and mortality rates were collected.
Conclusions:
The series revealed a greater incidence of post-traumatic ICH in boys (73.5%), whose average age was 6 years 5 months +/- 4 years 10 months (range 1 day to 15 years). Fifty-three percent of the girls suffered post-traumatic ICH before the age of 3, while 54% of the children were 7 years of age or older (P<0.05). Falls were the most frequent mechanism of injury causing CCT (36.3%), followed by vehicle accidents (33.6%) and unknown causes (15.9%), the latter mainly in children under 3 years old (31%). The most frequent symptoms were vomiting (58.6%), loss of consciousness (47.1%) and headaches (24.1%). Of all these children, 93.8% presented signs and symptoms at the time of hospital admission, alterations in the level of consciousness (66%), vomiting (47.2%) and headaches (26.4%) being among the most frequent. The hemorrhagic complications observed in the 113 patients took the form of extradural hematomas (EDH) in 75 (66.4%), of subdural hematomas (SDH) in 35 (31.0%), of hemorrhagic contusions (Hc) in 19 (16.8%), and of intracerebral hematomas (Ich) in 11 (9.7%). In 13 patients the site of the hematoma was the posterior cranial fossa (11.5%), and 22.1% of patients presented more than one type of hemorrhagic complication. Morbidity rates were 9.7% and mortality rates 17.7%.