Traumatic brain injury in Indian children

Area of Science:

• Neuroscience
• Pediatrics
• Public Health

Background:

• Traumatic brain injury (TBI) in children and adolescents presents a global health challenge, exacerbated by urbanization and motorization.
• Pediatric TBI is significantly more common than brain tumors, highlighting its impact on childhood mortality.
• Understanding the epidemiology and outcomes of TBI in pediatric populations is crucial for developing effective interventions.

Purpose of the Study:

• To analyze the epidemiological factors, management strategies, and outcomes of traumatic brain injury (TBI) in children and adolescents.
• To characterize the clinical spectrum of pediatric TBI cases presenting at a tertiary care hospital.

Main Methods:

• A prospective study conducted over two years (August 2015-July 2017) included pediatric patients (<16 years) with TBI.
• Data collected included clinical history, demographics, mode of injury, CT scan findings, interventions, morbidity, and mortality.
• Outcomes were assessed based on residual neurological deficits at discharge.

Main Results:

• Out of 76 pediatric TBI cases, 67% were male, with a mean age of 5.5 years. Road traffic accidents (RTA) were the most common cause (40.8%).
• Mild TBI accounted for 60.5% of cases. Common clinical presentations included loss of consciousness (47.3%) and vomiting (55%).
• Skull fractures (55.26%) and cerebral edema/contusion (48.68%) were frequent CT findings. Overall mortality was 5.26%, with 79% of survivors having no residual deficits.

Conclusions:

• Many pediatric TBI cases are preventable through parental vigilance and safe practices.
• Focusing on grading TBI severity is more critical than factors like age or mode of injury for determining outcomes.
• The majority of pediatric TBI survivors in this cohort experienced good recovery without significant long-term neurological deficits.