Aim To evaluate the incidence, modalities of treatment and outcome in paediatric patients with traumatic brain injury (TBI). Methods A retrospective cross-sectional study including 353 paediatric patients with head injury was carried out in the Department of Neurosurgery of University Clinical Centre Sarajevo during the period 1 July 2006-30 June 2012 (72 months). For each patient the lowest Glasgow Coma Scale (GCS) was established and the patient was accordingly classified as suffering from mild, moderate or severe TBI. Neuroimaging data included computer tomography (CT). Survival rates and method of treatment were compared according to age group, and matched with the total number of patients examined. Results A total of 353 children with head trauma were identified. A severe TBI (GCS < 8) was found in 33 (out of 353) children, mostly in the age group 11-18. Falls were the most common cause of trauma, followed by traffic accidents. Falls were the most common mechanism in the infants, preschool, and school children up to 10 years old; children aged 11-18 showed a higher rate of traffic accidents comparing to children younger than 3 years. Of 353 patients, 49 (13,9%) required surgical procedure, 304 (86.1%) were threated conservatively. Survival rate was 96.6 %. Conclusion The majority of hospitalized patients qualify for medical treatment and surgical intervention is reserved for selected cases. Thus, the adequate pre-hospital care is essential.
Bruns J, Hauser W. The epidemiology of traumatic brain injury: a review. Epilepsia. 2003. p. 2–10.
2.
Langlois J, Rutland-Brown W, Thomas K. The incidence of traumatic brain injury among children in the United States: differences by race. J Head Trauma Rehabil. 2005. p. 229–37.
3.
Moen K, Skandsen T, Folvik M, Brezova V, Kvistad K, Rydland J, et al. A longitudinal MRI study of traumatic axonal injury in patients with moderate and severe traumatic brain injury. J Neurol Neurosurg Psychiatry. 2012. p. 1193–200.
4.
Le T, Gean A. Neuroimaging of traumatic brain injury. Mt Sinai J Med. 2009. p. 145–62.
5.
Casey P, Mckenna M, Fiskum G, Saraswati M, Robertson C. Early and sustained alterations in cerebral metabolism after traumatic brain injury in immature rats. J Neurotrauma. 2008. p. 603–14.
6.
Calder I, Hill I, Scholtz C. Primary brain trauma in non-accidental injury. J Clin Pathol. 1984. p. 1095–1095.
7.
Nitecki S, Moir C. Predictive factors of the outcome of traumatic cervical spine fracture in children. J Pediatr Surg. 1994. p. 1409–10.
8.
Holmes J, Palchak M, Macfarlane T, Kuppermann N. Performance of the pediatric Glasgow Coma Scale in children with blunt head trauma. Acad Emerg Med. 2005. p. 814–9.
9.
Schutzman S, Greenes D. Pediatric minor head trauma. Ann Emerg Med. 2001. p. 65–9.
10.
Paul A, Adamo M. Non-accidental trauma in pediatric patients: a review of epidemiology, pathophysiology, diagnosis and treatment. Translat Paediatr. 2014. p. 195–7.
11.
Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths. 2002.
12.
Klimo P, Ragel B, Scott W, Jr, Mccafferty R. Pediatric neurosurgery during Operation Enduring Freedom. J Neurosurg Pediatr. 2010. p. 107–14.
13.
Podolsky-Gondim G, Furlanetti L, Viana D. Ballestero MFM, de Oliveira RS. The role of coagulopathy on clinical outcome following traumatic brain injury in children: analysis of 66 consecutive cases in a single center institution. Childs Nerv Syst. 2018. p. 2455–6.
14.
Kumar R, Mahapatra A. The changing “epidemiology” of pediatric head injury and its impact on the daily clinical practice. Childs Nerv Syst. 2009. p. 813–813.
15.
Majdan M, Plancikova D, Maas A, Polinder S, Feigin V, Theadom A, et al. Years of life lost due to traumatic brain injury in Europe: A cross-sectional analysis of 16 countries. PLoS Med. 2017. p. 1002331.
16.
Olesen J, Gustavsson A, Svensson M, Wittchen H, Jönsson B. The economic cost of brain disorders in Europe. Eur J Neurol. 2012. p. 155–7.
17.
Jalalvandi F, Arasteh P, Faramani S, Esmaeilivand R, M. Epidemiology of Pediatric Trauma and Its Patterns in Western Iran: A Hospital Based Experience. Glob J Health Sci. 2015. p. 139–45.
18.
Trefan L, Houston R, Pearson G. Epidemiology of children with head injury: a national overview. Arch Dis Child. 2016. p. 527–9.
19.
Jeong H, Choi S, Youm J, Lim J, Kwon H, Song S. Mortality and epidemiology in 256 cases of pediatric traumatic brain injury: Korean Neuro-Trauma Data Bank System (KNTDBS) 2010-2014. J Korean Neurosurg Soc. 2017. p. 710–6.
20.
Sieswerda-Hoogendoorn T, Boos S, Spivack B, Bilo R, Van Rijn Rr. Educational paper: Abusive Head Trauma part I. Clinical aspects. Eur J Pediatr. 2012. p. 415–23.
21.
Hawley C, Ward A, Long J, Owen D, Magnay A. Prevalence of traumatic brain injury amongst children admitted to hospital in one health district: a population-based study. Injury. 2003. p. 256–60.
22.
Chong SL, Harjanto S, Testoni D, Ng Z, Low C, Lee K, et al. Early hyperglycemia in pediatric traumatic brain injury predicts for mortality, prolonged duration of mechanical ventilation, and intensive care stay. Int J Endocrinol. 2015. p. 719476.
23.
Taylor C, Bell J, Breiding M, Xu L. Traumatic brain injury-related emergency department visits, hospitalizations, and deaths -United States. MMWR Surveill Summ. 2007. p. 1–16.
24.
Kuppermann N, Holmes J, Dayan P, Hoyle J, Jr, Atabaki S, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Pediatric Emergency Care Applied Research Network. PE-CARN; 2009. p. 1160–70.
25.
Dunning J, Daly J, Malhotra R, Stratford-Smith P, Lomas J, Lecky F, et al. Children’s Head injury Algorithm for the Identification of significant Clinical Events Study (CHALICE Study). The implications of NICE guidelines on the management of children presenting with head injury. Arch Dis Child. 2004. p. 763–7.
26.
Palchak M, Holmes J, Vance C, Gelber R, Schauer B, Harrison M, et al. A decision rule for identifying children at low risk for brain injuries after blunt head trauma. Ann Emerg Med. 2003. p. 493–6.
27.
Kafaki S, Alaedini K, Qorbani A, Asadian L, Haddadi K. Hyperglycemia: a predictor of death in severe head injury patients. Clin Med Insights Endocrinol Diabetes. 2016. p. 43–6.
28.
Luerssen T, Klauber M, Marshall L. Outcome from head injury related to patient’s age. A longitudinal prospective study of adult and pediatric head injury. J Neurosurg. 1988. p. 409–16.
29.
Berger M, Pitts L, Lovely M, Edwards M. Bartkowski HM. Outcome from severe head injury in children and adolescents. J Neurosurg. 1985. p. 194–9.
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