Paediatric head injury - abstract

ABSTRACT

All paediactric head injury cases admitted to the Port-of-Spain General Hospital, Trinidad in the 12 months from August 1981- July 1982 were studied. There were 306 cases of which 187 (61 percent) were males and 119 (39 percent) females. Causes of injury were falls 221 (72 percent), road traffic accidents 71 (23 percent) other accidents 12(3 percent) and child abuse (2 cases). The commonest clinical features were loss of consciousness 124 (40 percent), nausea and vomiting 114 (37 percent), scalp haematomas 102 (33 percent), scalp lacerations 57 (19 percent), headaches 39 (13 percent), bleeding from ear or nose 19 (6 percent), seizures 18 (6 percent), focal deficits 6 (2 percent). Skull fractures were present in 29 (9 percent). Surgical interventions was necessary in 9 cases. Elevation of compound depressed fractures 3, craniotomy for evacuation of acute subdural haematomas 1 and multiple exploratory burr holes 5 showing cerebral contusions 3, and cerebral oedema 2 cases. Mortality was only 3, all with brain stem injuries. Regarding mobidity, 2 patients had hemiparesis 1 abnormal mental state and 5 continued treatment for seizures. These figures compare well with studies done in UK the United States and Canada regarding sex incidence, causes of injury and symptomatology; however, they differ considerably from the adult head injury in Trinidad where males account for 90 percent, road traffic accidents 59 percent, fights 27 percent, and other causes only 14 percent. These figures also indicate that paediatric head injury demands vigorous treatment despite the initial findings, as the result may be much better than initially predicted (AU)