scholarly journals Epidemiology of children with head injury: a national overview

2016 ◽  
Vol 101 (6) ◽  
pp. 527-532 ◽  
Author(s):  
L Trefan ◽  
R Houston ◽  
G Pearson ◽  
R Edwards ◽  
P Hyde ◽  
...  
Keyword(s):  
Head Injury ◽  
Child Protection ◽  
Motor Vehicle ◽  
Social Deprivation ◽  
Descriptive Analysis ◽  
Skull Fracture ◽  
Neurological Impairment ◽  
Vehicle Accidents ◽  
School Aged Children ◽  
Trauma Networks

BackgroundThe National Confidential Enquiry describes the epidemiology of children admitted to hospital with head injury.MethodChildren (<15 years old) who died or were admitted for >4 h with head injury were identified from 216 UK hospitals (1 September 2009 to 28 February 2010). Data were collected using standard proformas and entered on to a database. A descriptive analysis of the causal mechanisms, child demographics, neurological impairment, CT findings, and outcome at 72 h are provided.ResultsDetails of 5700 children, median age 4 years (range 0–14.9 years), were analysed; 1093 (19.2%) were <1 year old, 3500 (61.4%) were boys. There was a significant association of head injury with social deprivation 39.7/100 000 (95% CI 37.0 to 42.6) in the least deprived first quintile vs. 55.1 (95% CI 52.1 to 58.2) in the most deprived fifth quintile (p<0.01). Twenty-four children died (0.4%). Most children were admitted for one night or less; 4522 (79%) had a Glasgow Coma Scale score of 15 or were Alert (on AVPU (Alert, Voice, Pain, Unresponsive)). The most common causes of head injury were falls (3537 (62.1%); children <5 years), sports-related incidents (783 (13.7%); median age 12.4 years), or motor vehicle accidents (MVAs) (401 (7.1%); primary-school-aged children). CT scans were performed in 1734 (30.4%) children; 536 (30.9%) were abnormal (skull fracture and/or intracranial injury or abnormality): 269 (7.6%) were falls, 82 (10.5%) sports related and 100 (25%). A total of 357 (6.2%) children were referred to social care because of child protection concerns (median age 9 months (range 0–14.9 years)).ConclusionsThe data described highlight priorities for targeted age-specific head injury prevention and have the potential to provide a baseline to evaluate the effects of regional trauma networks (2012) and National Institute of Health and Care Excellence (NICE) head injury guidelines (2014), which were revised after the study was completed.

Circumferential fracture of the skull base causing craniocervical dislocation

2002 ◽  
Vol 97 (1) ◽  
pp. 118-122 ◽  
Author(s):  
Ganesh Rao ◽  
Adam S. Arthur ◽  
Ronald I. Apfelbaum
Keyword(s):  
High Speed ◽  
Unusual Case ◽  
Motor Vehicle ◽  
Neurological Impairment ◽  
Craniocervical Junction ◽  
Motor Vehicle Accidents ◽  
Review Of The Literature ◽  
Content Type ◽  
Vehicle Accidents ◽  
Fine Print

✓ Fractures of the craniocervical junction are common in victims of high-speed motor vehicle accidents; indeed, injury to this area is often fatal. The authors present the unusual case of a young woman who sustained a circumferential fracture of the craniocervical junction. Despite significant trauma to this area, she suffered remarkably minor neurological impairment and made an excellent recovery. Her injuries, treatment, and outcome, as well as a review of the literature with regard to injuries at the craniocervical junction, are discussed.

Traumatic Intracranial Aneurysms in Childhood: Two Cases and a Review of the Literature

Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 398-408 ◽  
Author(s):  
Martin J. Buckingham ◽  
Kerry R. Crone ◽  
William S. Ball ◽  
Thomas A. Tomsick ◽  
Thomas S. Berger ◽  
...  
Keyword(s):  
Skull Base ◽  
Intracranial Aneurysms ◽  
Motor Vehicle ◽  
Skull Fracture ◽  
Penetrating Trauma ◽  
Gunshot Wounds ◽  
Male Predominance ◽  
Vehicle Accidents ◽  
Traumatic Aneurysms ◽  
Distal Anterior Cerebral Artery

Abstract Traumatic intracranial aneurysms in childhood are rare. To date, 67 well-documented cases in children have been reported. We present 2 additional cases and review the literature. Traumatic aneurysms can best be categorized based on mechanism of injury and location. Aneurysms secondary to penetrating trauma occur most commonly in teenage boys suffering gunshot wounds. Aneurysms secondary to nonpenetrating trauma occur at the skull base or in the periphery, with motor vehicle accidents and falls as the most common modes of injury. Skull base traumatic aneurysms most commonly involve the petrous, cavernous, or supraclinoid carotid artery and also show a predominance in teenage boys. Peripheral traumatic aneurysms can further be divided into distal anterior cerebral artery aneurysms secondary to trauma against the falcine edge and distal cortical artery aneurysms associated with an overlying skull fracture. Peripheral traumatic aneurysms tend to occur in younger patients with a less marked male predominance. Two-thirds of the patients suffered symptomatic aneurysmal hemorrhage, with an associated mortality rate of 31%. The clinical presentation, diagnosis, and treatment of traumatic intracranial aneurysms are discussed. (Neurosurgery 22:398-408, 1988)

Strategies for Helping Head-Injured Children Successfully Return to School

1987 ◽  
Vol 18 (4) ◽  
pp. 292-300 ◽  
Author(s):  
Roberta DePompei ◽  
Jean Blosser
Keyword(s):  
Head Injury ◽  
Motor Vehicle ◽  
Sports Injuries ◽  
Head Injuries ◽  
Closed Head Injury ◽  
Return To School ◽  
Educational Setting ◽  
Vehicle Accidents ◽  
Speech Language Pathologist ◽  
Head Injured

Each year approximately 75,000 individuals sustain a closed head injury (CHI). The head injuries may be the result of motor vehicle accidents, falls, sports injuries, or abuse. It is estimated that as many as 18,000 of those injured are children. Often, head-injured children return to the educational setting following physical recuperation. The communication, physical, cognitive, emotional, and/or behavioral changes which have resulted from the head injury may interfere with successful re-entry into school. This article will present information that may be helpful in implementing the CHI student's successful return to school. Specific topics to be discussed include: types of deficits in CHI students, initiating the return to the educational setting, reasons for involvement of the speech-language pathologist in the re-entry process, suggestions for establishing effective networks between the rehabilitation setting (hospital/clinic) and the educational setting; and, specific recommendations for implementing the return.

Serious Head Injury in Infants: Accident or Abuse?

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 340-342 ◽  
Author(s):  
M. Elaine Billmire ◽  
Patricia A. Myers
Keyword(s):  
Child Abuse ◽  
Head Injury ◽  
Medical Records ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Head Injuries ◽  
Skull Fracture ◽  
Intracranial Injury ◽  
Vehicle Accident ◽  
History Of

The medical records and computed tomography (CT) scans of all children less than 1 year of age admitted to the hospital with head injury over a 2-year period were reviewed. Sixty-four percent of all head injuries, excluding uncomplicated skull fracture, and 95% of serious intracranial injuries were the result of child abuse. The occurrence of intracranial injury in infants, in the absence of a history of significant accidental trauma, such as a motor vehicle accident, constitutes grounds for an official child abuse investigation.

Head Injury in Very Young Children: Mechanisms, Injury Types, and Ophthalmologic Findings in 100 Hospitalized Patients Younger Than 2 Years of Age

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 179-185 ◽  
Author(s):  
A. C. Duhaime ◽  
A. J. Alario ◽  
W. J. Lewander ◽  
L. Schut ◽  
L. N. Sutton ◽  
...  
Keyword(s):  
Head Injury ◽  
Young Children ◽  
Motor Vehicle ◽  
Head Injuries ◽  
Older Children ◽  
Retinal Hemorrhages ◽  
Injury Type ◽  
Vehicle Accidents ◽  
Very Young Children ◽  
Injured Patients

Head injury in the youngest age group is distinct from that occurring in older children or adults because of differences in mechanisms, injury thresholds, and the frequency with which the question of child abuse is encountered. To analyze some of these characteristics in very young children, the authors prospectively studied 100 consecutively admitted head-injured patients 24 months of age or younger who were drawn from three institutions. Mechanism of injury, injury type, and associated injuries were recorded. All patients underwent ophthalmologic examination to document the presence of retinal hemorrhages. An algorithm incorporating injury type, best history, and associated findings was used to classify each injury as inflicted or accidental. The results confirmed that most head injuries in children younger than 2 years of age occurred from falls, and while different fall heights were associated with different injury types, most household falls were neurologically benign. Using strict criteria, 24% of injuries were presumed inflicted, and an additional 32% were suspicious for abuse, neglect, or social or family problems. Intradural hemorrhage was much more likely to occur from motor vehicle accidents and inflicted injury than from any other mechanism, with the latter being the most common cause of mortality. Retinal hemorrhages were seen in serious accidental head injury but were most commonly encountered in inflicted injury. The presence of more serious injuries associated with particular mechanisms may be related to a predominance of rotational rather than translational forces acting on the head.

Head Trauma in Children

1994 ◽  
Vol 15 (6) ◽  
pp. 213-219
Author(s):  
Brahm Goldstein ◽  
Karen S. Powers
Keyword(s):  
Head Injury ◽  
Hospital Admissions ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Head Injuries ◽  
Motor Vehicle Accidents ◽  
Initial Assessment ◽  
Severe Injuries ◽  
Vehicle Accidents ◽  
Pediatric Head Injury

Head injury, either alone or in association with multiple other injuries, is extremely common. The initial assessment and management of children who have a head injury is an important topic for all pediatricians. Epidemiology Table 1 lists definitions of minor, moderate, and severe head injuries as determined by the initial neurologic presentation. The most common method to assess a child's neurologic status initially is to assign a score based on the Glasgow Coma Scale (GCS). The GCS is determined by eye opening and best verbal and motor responses (Tables 2 and 3). Mild-to-moderate head injuries are far more common than severe injuries in the pediatric population. More than 90% of children requiring admission to a hospital following head injury have a GCS score of 13 to 15; severe head injury (GCS≤ 8) accounts for approximately 5% of admissions. Motor vehicle accidents, bicycle accidents, falls, sporting accidents, assaults, and child abuse are the most common causes of pediatric head injury. Despite a significant reduction in the number of pediatric fatalities due to implementation of the 55 mile/hour speed limit, motor vehicle accidents still result in a large number of hospital admissions and deaths each year. Many of these accidents are associated with drug or alcohol abuse.

scholarly journals Surgical Outcome of Isolated Extradural Hematomas Operated in a Teaching Hospital in Western Nepal

2019 ◽  
Vol 16 (1) ◽  
pp. 21-24
Author(s):  
Balgopal Karmacharya ◽  
Nikunja Yogi ◽  
Benju Pun
Keyword(s):  
Head Injury ◽  
Teaching Hospital ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Age Groups ◽  
Female Ratio ◽  
Vehicle Accidents ◽  
Time Period ◽  
Number Of Patients ◽  
Male Female Ratio

The aim of this determine the causes, frequency, location of isolated extradural hematomas in patients presenting with head injury and to find out the outcome of surgery in such patients. This is prospective observational study was conducted in the Neurosurgery Unit of Manipal Teaching Hospital from January 2012 to January 2017. All patients who presented with headinjury and had isolated extradural hematomas were included in the study. Total number of patients admitted with diagnosis of extradural hematomas during that time period was 169 among which 94 patients underwent surgical treatment. Descriptive statistics data including age, gender, causes of injury, severity of head injury and Glasgow outcome scale were studied. Results in proportion and percentages were calculated by using Microsoft Excel 2013. There were 169 patients who had isolated extradural hematomas. Among them, 75 patients were managed conservatively and 94 underwent craniotomy for evacuation of hematoma. This group of 94 patients who operative treatment was taken for this study. Male: female ratio was 1.6:1. Mean age was 23 years. Most of patients were in 20-40 age groups. Causes of extradural hematomas included motor vehicle accidents, falls and assaults. Mild and moderate head injury was present in 53 (56.38%) and 32 (34.0%) patients. Seventy nine patients (84.05%) of patients had good recovery while 3 (3.19%) patients expired.

scholarly journals Management of supratentorial epidural hematoma in children: report on 49 patients

2010 ◽  
Vol 68 (6) ◽  
pp. 888-892 ◽  
Author(s):  
Wellingson Silva Paiva ◽  
Almir Ferreira de Andrade ◽  
Luis Mathias Júnior ◽  
Vinicius Monteiro de Paula Guirado ◽  
Robson Luis Amorim ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Neurological Status ◽  
Neurological Impairment ◽  
Common Symptom ◽  
Traumatic Head Injury ◽  
Patients Âgés ◽  
Vehicle Accidents ◽  
Long Term Follow Up ◽  
History Of

Traumatic head injury is a common cause of mortality and acquired neurological impairment in children. However, pediatric epidural hematomas (EDHs) are not common and few series have studied the evolution of these patients. In this study, we present the results from a sample of patients with EDH with long-term follow-up. METHOD: Between January 2006 and December 2008, 49 patients with traumatic EDH were treated at our unit. Clinical course, radiological findings and outcomes were evaluated. Neurological status was assessed using the Glasgow Coma Scale (GCS). The patients' ages ranged from one day to 16 years. The mean follow-up was six months. RESULTS: On admission, most of the patients presented mild trauma and 57% had a GCS of 13-15. The most common symptom was irritability. The most frequent mechanisms of injury were: falling from a height in 29 cases and motor vehicle accidents in 16 cases. Three of these patients presented GCS 3, but only one died. We found a late neurological deficit in nine patients. CONCLUSION: These lesions may occur following mild head trauma and in alert children with nonfocal neurological examinations. However, in children presenting irritability with subgaleal hematomas and a history of loss of consciousness, skull computed tomography must be performed.

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