Spectrum of Pediatric Head Injury with Management and Outcome: A Single Tertiary Care Center Study

Abstract

Objective This study aims to conduct a survey on the pediatric head injury cases admitted to our hospital to identify the incidence, age, sex, mechanism and type of injury, other associated injuries, initial presentations, computed tomography finding, management, length of hospital stay, outcome in the form of condition at discharge, and outcome analysis using Glasgow outcome score (GOS).

Methods This is a retrospective study of all children ≤ 18 years admitted for head injury to our hospital during the period August 2013 to June 2014. A total of 247 pediatrics head injury patients in between the age of 0 and 18 years were admitted and treated. In all cases age, sex, presenting symptoms, mechanism, type, severity, other associated injuries, management, duration of hospital stay, GOS, and so on, are analyzed from the stored pediatrics master register, computerized discharge tickets, patients profiles, admission register, death register, and bed head tickets.

Results Of all the patients, there was a male preponderance (p < 0.001). The most common presenting feature was altered sensorium. The mean duration of hospitalization in our study is 4.0615 with 89.06% of patients staying < 7 days (p-value ≤ 0.001). Most common mechanism of head injury in children was found as road traffic accident (p < 0.001). Most common type of injury was extradural hematoma and about 62% intracranial pathology shows no skull fracture. Mortality rate is low as compared to all head trauma victims.

Conclusion Outcome of pediatric head injury depends on initial presentation. Early recognition and prompt management contributes to decrease mortality and disability. Younger males are at a greater risk. Most injuries are mild-to-moderate in nature with high rate of good recovery.

Keywords

pediatric - head injury - Glasgow coma scale - GCS - Glasgow outcome scale - GOS - computed tomography - CT

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