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Published on: August 16, 2019
Severe Traumatic Brain Injury Cases among Children Younger than 24 Months
Turgut Dolanbay1, Hüseyin Fatih Gül2, Abdullah Talha Şimşek3
1Department of Medical Emergency, Kafkas University Medical School, Kars, Turkey, turgutdolanbay@hotmail.com.
Insights
Severe traumatic brain injury (TBI) in children under two years old is life-threatening. Lower hemoglobin and hematocrit levels indicate a higher fatality risk in these pediatric TBI cases.
Area of Science:
- Pediatric Traumatology
- Neurocritical Care
- Emergency Medicine
Background:
- Accidental head injuries frequently cause traumatic brain injury (TBI).
- Clinical assessment of TBI in children under two years old is challenging.
- Research on TBI in infants and toddlers remains limited.
Purpose of the Study:
- To review severe accidental head injuries in children aged 0-2 years.
- To evaluate the incidence, distribution, and clinical outcomes of pediatric TBI.
- To analyze TBI cases in the Kars Province of Turkey.
Main Methods:
- Retrospective chart review of 26 pediatric TBI cases.
- Data collected from Kars Harakani Hospital Emergency Department (2017-2019).
- Analysis of patient demographics, injury causes, and types of intracranial hemorrhage.
Main Results:
- Falls were the most common cause of head trauma.
- Hemorrhagic injuries included subarachnoid, subdural, and epidural hematomas.
- Five fatalities were recorded, with equal male and female distribution.
Conclusions:
- Severe TBI in children under two years presents a critical health risk.
- Reduced hemoglobin (HGB) and hematocrit (HCT) levels correlate with increased fatality.
- Monitoring HGB and HCT may aid in assessing TBI prognosis in young children.
Introduction:
Accidental head injuries are known to cause serious traumatic brain injury (TBI). Children younger than 2 years of age build a separate group that is more difficult to assess clinically. Investigations targeting TBIs in pediatric cases, particularly in those between 0 and 2 years of age, are limited.
Objective:
In this study, we reviewed a number of severe accidental head injuries in a cohort of children aged 0-2 years to evaluate the relative incidence, distribution, and clinical success in determining the nature of the cases in the Kars Province of Turkey.
Methods:
The study targeted 26 -cases who presented to the Emergency Department of Kars Harakani Hospital for TBI between 2017 and 2019 through retrospective chart review.
Results And Conclusions:
Among the children who presented to the emergency clinic, 2 were newborns, 7 were <1 year of age, and the remaining 17 cases were between 1 and 2 years old. The number of male and female patients was equal, and 5 fatality cases were observed. The most frequent cause of head trauma were falls. We deduced that 6 cases had subarachnoid hemorrhage, 2 cases had subdural hemorrhage, 3 cases had epidural hemorrhage, and 4 cases had contusion. We compared the mean level of the two blood parameters hemoglobin (HGB) and hematocrit (HCT) between fatal and surviving cases and detectedthat both values decreased dramatically in exitus cases. The higher fatality rate in the present study could be attributed to the fact that we targeted only the severe TBI cases. Severe TBI in children younger than 2 years results in a life-threating situation. The risk of fatality might be deduced from the reduction of the HGB and HCT levels as it is significantly lower in fatal cases than in surviving cases.
