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Published on: January 20, 2023
[Traumatic head injury in children in south Tunisia epidemiology, clinical manifestations and evolution. 454 cases]
Mabrouk Bahloul1, Hedi Chelly, Riadh Gargouri
1Service de Rédanimation polyvalente, CHU H. Bourguiba Sfax Tunisie.
Insights
Traumatic head injuries in children are common in Tunisia, primarily caused by traffic accidents. The study found a high mortality rate of 18% and emphasizes the need for prevention strategies.
Area of Science:
- Pediatric Traumatology
- Neurocritical Care
- Epidemiology of Injury
Context:
- Head injuries represent a significant cause of hospitalization in children in Tunisia.
- Traffic accidents are the leading cause of traumatic head injury in this pediatric population.
Purpose:
- To investigate the epidemiological characteristics, causes, clinical and paraclinical features, and outcomes of pediatric traumatic head injuries in South Tunisia.
- To analyze data from 454 children admitted to the Intensive Care Unit over an 8-year period.
Summary:
- The study identified traffic accidents as the primary cause (69.4%) of head injuries in children, with a mean age of 7.2 years.
- Cerebral CT scans revealed significant abnormalities in 86.3% of cases, including meningeal hemorrhage and cerebral contusions.
- A high incidence of secondary systemic insults (83%) was noted, contributing to a poor short-term prognosis with an 18% mortality rate.
Impact:
- The findings highlight the severe impact of traumatic head injuries on children in Tunisia, with a substantial mortality rate.
- Results underscore the critical need for targeted prevention efforts, particularly concerning road traffic safety for children.
- This research provides valuable epidemiological data for neurotrauma management and public health interventions in the region.
Aim:
To determine epidemiological, causes, clinical and Para clinical manifestations and outcome in children with traumatic head injury in south Tunisia.
Methods:
A retrospective study over a 8 year period (1997-2004) of 454 children's with head injury admitted to the Intensive Care Unit (ICU) of a university hospital (Sfax-Tunisia). Basic demographic, clinical, biological and radiological data were recorded on admission and during the ICU stay.
Results:
Mean age (+/- SD) was of 7.2 +/-3.8 years. The main cause of trauma was traffic accidents (69.4%). There were a predominance of male patient's with a sex-ratio of 2.21. The Score of coma of Glasgow adapted to the child, was on average from 8 +/- 3 points. Extra-cranial pathology was present were observed in 38.9%. The cerebral CT-Scan performed on admission for all patients was pathological in 86.3% of the cases. The most observed lesions were meningeal Haemorrhage (35.2%) and the cerebral contusion (34.5%). According to the "Traumatic Coma Dated Bank classification" we noted a high proportion of type 2 group (46%). Secondary systemic insults were observed in 377 children (83%). Evolution was marked by the death of 82 children (18%). Among survivors, a good recovery was observed in 229 children (50.4%).
Conclusion:
In Tunisia, head injury is a frequent cause of hospitalization. It is essentially involved in traffic accidents. The short term prognosis is poor with a high (18%) mortality. Prevention is highly advised.
