Spectrum and outcome of traumatic brain injury in children <15 years: A tertiary level experience in India

Abstract

Background:Though, traumatic brain injury (TBI) has been documented as the single most common cause of morbidity and mortality in infancy and childhood, the exact incidence is unavailable in India. Moreover, modes of injury, mechanisms of damage, and management differ significantly from that of an adult.Aims and Objectives:To analyze the epidemiological factors, the spectrum of TBI, modes of injury, types of injury, and the outcome in the children <15 years with TBI.Materials and Methods:This is a retrospective study from August 2012 to May 2013 at Department of Neurosurgery, S.C.B. Medical College, Cuttack, Odisha, India. All the pertinent details from case records of hundred and forty-seven children <15 years with TBI were analyzed. Follow-up was done for 6 months at outpatients department.Results:Age wise, incidence and severity of TBI is more common in 10–15 years. Males outnumber females with a male: female ratio 2.19:1. Overall, road traffic accident (RTA) is the commonest mode of injury. Assault is not uncommon (7.48% cases). Falls is common in <5 years while RTA is common in 5–15 years. The extradural hematoma was the most common injury pattern; however, surgical consideration was maximal for fracture skull. Overall mortality was 7.48%. Diffuse axonal injury has the maximum individual potential for mortality. We noticed excellent recovery in 68.7%, disabilities in 17.68%, and persistent vegetative state in 5.45% cases.Conclusion:TBI in children carries good outcome, if resuscitated and referred early to a neurotrauma center, and managed subsequently on an individualized basis with a well-organized team approach. Severe TBI in children has a poor outcome.

Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study

“…Head CT scan was ordered in 70.7% of study subjects and showed various types of skull bone fractures, brain contusion, intracranial bleeding, and diffuse axonal injury. ese findings are in agreement with studies done in India, Tunisia, and Nigeria, and head CTscan requests conform to the recommended neurosurgical practice [22,25,30,37,39].…”

“…Concerning mechanisms of injury, unintentional pedestrian RTA and falls were the most common causes followed by intentional fights/violence injuries. is is in line with most of the studies done in developing countries [2,8,18,22,30,34,[37][38][39].…”

“…Our study subjects had hypotension, lost consciousness, convulsion, and increased intracranial pressure sign at presentation. Comparable reports were documented in other studies [30,37].…”

“…is finding is in agreement with Nigerian, South African, and Tunisian studies. is could be related to boy's risk-prone behavior resulting in high energy transfer and their outdoor engagement [14,30,[34][35][36][37]. Concerning mechanisms of injury, unintentional pedestrian RTA and falls were the most common causes followed by intentional fights/violence injuries.…”

Retrospective study of impact of social factor in pediatric trauma at teaching hospital of Vindhya region of India

“…5,6 There are many studies on trauma in children; they mainly represent the scenario in developed countries. There is a paucity of studies from developing countries like India.…”