Pediatric head injuries: a retrospective analysis of 280 patients

BACKGROUND: To assess etiological factors, clinical features, radiological findings and recovery rates in pediatric head injuries. METHODS: Patients (n =280) with head injuries (age range: 0 - 16 years) hospitalized in Trakya University Department of Neurosurgery between January 1995 and 2004 were analyzed statistically. RESULTS: According to Glasgow Coma Scale (GCS) the patients had minor (GCS: 13- 15 ; 70.1% ), moderate (GCS: 9- 12; 17,1% ), or severe (GCS: 3 to 8; 6,8% ). head injuries The most common etiological factor was fall from a height (34,3%); and the most frequently associated injury was extra-spinal skeletal injury (12,9%). Fifty-one patients (18,2%) underwent neurosurgical operation. 87.5% of them recovered completely, while 12,5% showed partial recovery or died, as graded by Glasgow Outcome Scale (GOS). There was a moderately strong correlation between initial GCS and GOS (r=0,53, p=0,01). CONCLUSIONS: Nearly half of the pediatric head injuries were caused by falls with good prognoses. In the school age, motor vehicle accident (MVA) was the most frequent trauma type. MVA was the most serious type of trauma as demonstrated by its low GCS and GOS scores. Polytraumas, subdural hematomas, cerebral contusions, subarachnoid or intracerebral hemorrhages, cerebral edemas, diffuse axonal injuries, and any cranial lesion which required surgery were found to be related with poor prognosis.