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[Traumatic brain injury in paediatrics. Our results]
A J Lacerda Gallardo1, D Abreu Pérez
1Servicio de Neurocirugía, Hospital General de Morón, Morón, Ciego de Avila, Cuba.
Insights
Mild traumatic brain injuries (TBI) are common in children. Implementing tailored treatment strategies can reduce hospital admissions for mild TBI cases, improving patient outcomes.
Area of Science:
- Pediatric Traumatology
- Neurology
- Emergency Medicine
Context:
- Traumatic brain injuries (TBI) are a significant cause of pediatric hospital admissions, with high mortality rates.
- An estimated 600,000 consultations and 250,000 hospitalizations occur annually in children due to TBI.
- TBI accounts for 75% of traumatic injuries in hospitalized children.
Purpose:
- To describe the clinical characteristics and outcomes of pediatric traumatic brain injuries.
- To evaluate the severity distribution and treatment approaches for TBI in children.
- To assess the effectiveness of the Glasgow Coma Scale (GCS) and Glasgow Results Scale (GRS) in classifying TBI severity.
Summary:
- A descriptive observational study analyzed 339 pediatric TBI cases from January to December 2001.
- The majority of cases (97%) were mild TBI, with only 2.4% moderate and 0.6% severe.
- Most mild TBI cases (64%) received ambulatory treatment, while 36% required hospitalization. Two deaths (1.8%) and no disabilities were reported.
Impact:
- Mild TBI is the predominant form of TBI in the pediatric population studied.
- Optimizing treatment protocols tailored to medical center capabilities can decrease hospital admissions for mild TBI.
- The study highlights the importance of appropriate management for reducing TBI-related morbidity and mortality in children.
Introduction:
75% of all children admitted to hospital with traumatic injuries involve traumatic brain injuries (TBI), 70% of the deaths occur within the first 48 hours and mortality fluctuates between 20 and 35%. It is estimated that every year 600,000 consultations are made for this reason, 300 out of every 100,000 children suffer a TBI and about 250,000 cases involve hospitalisation.
Patients And Methods:
A descriptive observational study was carried out of all the patients of paediatric age who attended our Casualty Department in the period between January and December 2001, and had suffered a TBI in any of its clinical variations. The Glasgow coma scale (GCS) was used to classify cases according to their seriousness and results were defined by employing the Glasgow results scale (GRS).
Results:
A survey of 339 cases with TBI was performed, of which 329 (97%) were mild, eight (2.4%) moderate and two (0.6%) were serious. Of the first, 122 (36%) required hospitalisation and the remaining 217 (64%) were given ambulatory treatment (all of them had mild TBI). Complementary examinations carried out were simple head X rays in 117 (95.9%). CAT (computerised axial tomography) scans were only performed in three cases (2.5%). Only two (1.8%) deaths occurred in our series and there were no cases of disability, according to the GRS.
Conclusions:
Mild TBI was the common event in our series. Application of treatment systems that are suited to the conditions in each medical centre helps to reduce the number of hospital admissions for mild TBI.