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Aetiological patterns and management outcome of paediatric head trauma: one-year prospective study
1Neurosurgery Unit, Department of Surgery, Nnamdi Azikiwe University TeachingHospital, Nnewi, Anambra State, Nigeria. judekenny2003@yahoo.com
Insights
Road traffic accidents, particularly motorcycle injuries, are now the leading cause of paediatric head trauma in Nigeria. While most cases have satisfactory outcomes, this trend highlights a critical public health concern for child safety.
Area of Science:
- Pediatric Trauma Care
- Neurotrauma Epidemiology
- Public Health Interventions
Background:
- Trauma is the leading cause of death in children, with head injuries accounting for 75% of fatalities.
- Falls have historically been the primary cause of paediatric head trauma.
- Recent data from Nigeria suggests a shift towards road traffic accidents as the predominant cause.
Purpose of the Study:
- To investigate the causes of paediatric head trauma in Nigeria.
- To analyze management strategies and patient outcomes.
- To establish baseline data for developing injury prevention measures.
Main Methods:
- A prospective study was conducted over 12 months at Nnamdi Azikiwe University Teaching Hospital, Nnewi.
- Paediatric patients (age <= 15 years) with head trauma were included.
- Glasgow Coma Scale and Glasgow Outcome Scale were used for injury grading and outcome assessment.
Main Results:
- Out of 334 trauma cases, 52 (24.8%) involved paediatric head trauma.
- Falls and road traffic accidents (RTAs) were equally responsible in 48.1% of cases.
- Mild head injury was observed in 59.6% of patients, with a 15.4% mortality rate and 69.2% satisfactory outcomes.
Conclusions:
- Road traffic injuries, especially from motorcycles, are the primary cause of paediatric head trauma and associated mortality in the region.
- Male children are disproportionately affected.
- Management protocols yield mostly satisfactory outcomes, but prevention strategies are crucial.
Background:
Trauma is the most common cause ofpaediatric deaths. In 75% ofpaediatric trauma deaths, head injury is responsible, and most are from falls. Recent reports from Nigeria, however, appear to indicate a predominance of road traffic accidents, instead of falls.
Objective:
To evaluate the aetiology of paediatric head trauma, management protocols and outcome from our Centre, in order to acquire a baseline data base and recommend measures to reduce childhood trauma.
Patients And Methods:
A prospective study of all paediatric head trauma cases presenting to Nnamdi Azikiwe University Teaching Hospital, Nnewi, for 12months from April 21, 2006 to April 20, 2007, was done and collated data subsequently analyzed. The paediatric age group was taken as = 15 years, and grading of head injury was with the Glasgow Coma Scale (3-15) and the modified scale for non-verbal children; while outcome was measured with the Glasgow Outcome Scale (1-5).
Results:
Out of 334 patients treated within the period of study, 210 were head trauma cases. Of these, 52 were paediatric head trauma, representing 24.8% of all head trauma cases; and 19.2% (10 of 52) of them were aged 0-2 years. About 62% (32 of 52) were males. Falls and RTA were each responsible in 25 (48.1%) cases. Mild head injury occurred in 31 (59.6%), and 49 (94.2%) patients were evaluated by plain radiography. Treatment was conservative in 39 (75%) cases; with satisfactory outcome in 36 (69.2%), and a mortality rate of 15.4%.
Conclusions:
Road traffic injury, mostly from motorcycles, has become the major cause of morbidity and mortality amongst the paediatric age group, especially the male gender, and outcome from management is mostly satisfactory.
