Pediatric Traumatic Brain Injury Patients in Southwestern Nigeria: Presentation Patterns and Outcome

Traumatic brain injury (TBI) is less common in children than in adults but is a leading cause of mortality in children globally. The study aimed to explore the prevalence, etiological factors, management, and outcomes of pediatric TBI at Lagos University Teaching Hospital (LUTH), a major referral center in Nigeria.

This prospective study included children under 18 diagnosed with TBI from January 1 to December 31, 2022. Ethical clearance was obtained, and informed consent was collected from caregivers. Data were gathered using a pre-designed proforma covering socio-demographics, injury mechanisms, pre-hospital management, clinical findings, and outcomes. Analysis was performed using IBM SPSS Statistics(v28).

Twenty-six patients with a mean age of 9.0 ± 5.99 years with a male-to-female ratio of 1.6:1 were enrolled. Only two (7.7%) had health insurance. Pediatric TBI accounted for 0.03% of all surgical emergencies at LUTH. Road traffic accidents (RTAs) were the cause for TBI in 11 (42.3%) of cases, whereas falls (7, 26.9%) and household accidents (5, 19.2%) were leading non-RTA causes. Only one patient (3.8%) was selected by skilled personnel and received immediate C-spine stabilization. Only 15 (57.7%) had a CT scan, constrained by financial issues. Four (15.4%) required surgery, but only half of them could undergo surgery due to financial constraints. Only one patient needed ICU admission, and three patients (11.5%) died. Mortality was only seen in severe TBI cases.

The study found a low prevalence of pediatric TBI but highlighted significant mortality, especially in severe cases. Poverty and lack of health insurance were major factors affecting outcomes.