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[Pediatric head injuries: a retrospective analysis of 280 patients.]
Osman Şimşek1, Tufan Hiçdönmez, M Kemal Hamamcıoğlu
1Trakya University Faculty of Medicine, Departments of Neurosurgery Edirne, Turkey. gosimsek@yahoo.com.
Insights
Pediatric head injuries are often caused by falls, with most children recovering well. However, severe injuries like motor vehicle accidents and those requiring surgery indicate a poorer prognosis.
Area of Science:
- Pediatric Neurosurgery
- Trauma Care
- Epidemiology of Head Injury
Context:
- Head injuries in children are a significant public health concern.
- Understanding etiological factors and clinical presentations is crucial for effective management.
Purpose:
- To assess etiological factors, clinical features, radiological findings, and recovery rates in pediatric head injuries.
- To analyze the correlation between initial injury severity and long-term outcomes.
Summary:
- A retrospective analysis of 280 pediatric patients (0-16 years) with head injuries revealed falls as the most common cause (34.3%).
- Minor head injuries (GCS 13-15) constituted 70.1%, with 87.5% achieving complete recovery (GOS).
- Motor vehicle accidents (MVAs) were associated with more severe injuries (lower GCS/GOS) and poorer prognoses, especially in school-aged children.
Impact:
- Identifies falls as a primary cause of pediatric head trauma, emphasizing the need for preventative measures.
- Highlights the critical role of the initial Glasgow Coma Scale (GCS) in predicting long-term Glasgow Outcome Scale (GOS) outcomes.
- Underscores the severe implications of MVAs and surgically treated cranial lesions in pediatric head injury cases.
Background:
To assess etiological factors, clinical features, radiological findings and recovery rates in pediatric head injuries.
Methods:
Patients (n =280) with head injuries (age range: 0 - 16 years) hospitalized in Trakya University Department of Neurosurgery between January 1995 and 2004 were analyzed statistically.
Results:
According to Glasgow Coma Scale (GCS) the patients had minor (GCS: 13- 15 ; 70.1% ), moderate (GCS: 9- 12; 17,1% ), or severe (GCS: 3 to 8; 6,8% ). head injuries The most common etiological factor was fall from a height (34,3%); and the most frequently associated injury was extra-spinal skeletal injury (12,9%). Fifty-one patients (18,2%) underwent neurosurgical operation. 87.5% of them recovered completely, while 12,5% showed partial recovery or died, as graded by Glasgow Outcome Scale (GOS). There was a moderately strong correlation between initial GCS and GOS (r=0,53, p=0,01).
Conclusions:
Nearly half of the pediatric head injuries were caused by falls with good prognoses. In the school age, motor vehicle accident (MVA) was the most frequent trauma type. MVA was the most serious type of trauma as demonstrated by its low GCS and GOS scores. Polytraumas, subdural hematomas, cerebral contusions, subarachnoid or intracerebral hemorrhages, cerebral edemas, diffuse axonal injuries, and any cranial lesion which required surgery were found to be related with poor prognosis.
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