Clinicoepidemiologic Profile of Pediatric Traumatic Brain Injury: Experience of a Tertiary Care Hospital From Northern India

Traumatic brain injury is an important cause of acquired brain injury. The current study brings to light the clinicoepidemiologic profile of pediatric traumatic brain injury in India. Retrospective record analysis of children (aged ≤ 16 years) with traumatic brain injury presenting to an apex-trauma-center in North India over 4 years was done. Of more than 15 000 patients with a suspected head injury, 4833 were children ≤16 years old. Of these, 1074 were admitted to the inpatient department; 65% were boys with a mean age at presentation being 6.6 years. Most patients (85%) had a Glasgow Coma Scale score of 13 to 15 at presentation while Glasgow Coma Scale scores of ≤8 was seen in 10% of patients. Neuroimaging (computed tomography [CT]) abnormalities were seen in 12% of patients, with the commonest abnormality being skull fracture, followed by contusions, and extradural hemorrhage. Around 2% of patients required decompressive craniotomy whereas 3% of patients succumbed to their illness. Among the inpatients with pediatric traumatic brain injury, two-thirds were boys with a mean age at presentation of 7.6 years. Severity of traumatic brain injury varied as mild (64%), moderate (11%), and severe (25%). The most common mode of injury was accidental falls (59%) followed by road traffic and rail accidents (34%). Neuroimaging abnormalities were seen in half of inpatients with pediatric traumatic brain injury, with the commonest abnormality being skull fracture. Pediatric head injuries are an important public health problem and constitute a third of all head injuries. They are more common in boys, and the most common modes of injury are accidental falls, followed by road traffic accidents.

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Clinico-radiologic Profile of Pediatric Traumatic Brain Injury in Western Rajasthan

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_269_17 ◽

2018 ◽

Vol 09 (02) ◽

pp. 226-231 ◽

Cited By ~ 2

Author(s):

Pawan Kumar Dara ◽

Manish Parakh ◽

Shyama Choudhary ◽

Hemant Jangid ◽

Priyanka Kumari ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Hospital Stay ◽

Road Traffic ◽

Tertiary Care ◽

Care Hospital ◽

Pediatric Traumatic Brain Injury ◽

Csf Rhinorrhea ◽

Temporal Bone Fracture ◽

Fall From Height

ABSTRACTObjective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI). Design: Prospective observational study Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. S. N. Medical College, Jodhpur (tertiary care hospital). Participants: A total of 188 children (1 month–18 years) were enrolled and 108 admitted. Intervention: TBI classified as mild, moderate, or severe TBI. Neuroimaging was done and managed as per protocol. Demographic profile, mode of transport, and injury were recorded. Outcome: Measured as hospital stay duration, focal deficits, mortality, and effect of early physiotherapy. Results: Males slightly outnumbered females mean age was 5.41 ± 4.20 years. Fall from height was the main cause of TBI (61.11%) followed by road traffic accident (RTA) (27.78%). Majority (56.56%) reached hospital within 6 h of injury, out of which 27% of patients were unconscious. Mild, moderate, and severe grade of TBI was seen in 50%, 27.78%, and 22.22% of cases, respectively. About 12.96% of cases required ventilator support. The average duration of hospital stay was 11.81 ± 12.9 days and was lesser when physiotherapy and rehabilitation were started early. In all children with temporal bone fracture, magnetic resonance imaging (MRI) brain revealed a temporal lobe hematoma and contusion in spite of initial computed tomography (CT) head normal. Children who have cerebrospinal fluid (CSF) rhinorrhea/otorrhea had a high chance of fracture of base of skull and contusion of the basal part of the brain. Conclusion: In India, fall from height is common setting for pediatric TBI besides RTA. Early initiation of physiotherapy results in good outcome. MRI detects basal brain contusions in children presenting with CSF rhinorrhea/otorrhea even if initial CT brain is normal.

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Prehospital Versus Trauma Center Glasgow Coma Scale in Pediatric Traumatic Brain Injury Patients

Journal of Surgical Research ◽

10.1016/j.jss.2019.03.038 ◽

2019 ◽

Vol 241 ◽

pp. 112-118 ◽

Cited By ~ 1

Author(s):

Joseph D. Drews ◽

Junxin Shi ◽

Dominic Papandria ◽

Krista K. Wheeler ◽

Eric A. Sribnick ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Glasgow Coma Scale ◽

Trauma Center ◽

Pediatric Traumatic Brain Injury ◽

Coma Scale

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Cerebrospinal Fluid Biomarkers versus Glasgow Coma Scale and Glasgow Outcome Scale in Pediatric Traumatic Brain Injury: The Role of Young Age and Inflicted Injury

Journal of Neurotrauma ◽

10.1089/neu.2006.0062 ◽

2007 ◽

Vol 24 (1) ◽

pp. 75-86 ◽

Cited By ~ 45

Author(s):

Paul M. Shore ◽

Rachel P. Berger ◽

Sumeeta Varma ◽

Keri L. Janesko ◽

Stephan R. Wisniewski ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Cerebrospinal Fluid ◽

Brain Injury ◽

Glasgow Coma Scale ◽

Glasgow Outcome Scale ◽

Young Age ◽

Pediatric Traumatic Brain Injury ◽

Coma Scale ◽

Cerebrospinal Fluid Biomarkers

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Glasgow Coma Scale as a predictor for hemocoagulative disorders after blunt pediatric traumatic brain injury*

Pediatric Critical Care Medicine ◽

10.1097/pcc.0b013e31823893c5 ◽

2012 ◽

Vol 13 (4) ◽

pp. 455-460 ◽

Cited By ~ 18

Author(s):

Sigune Peiniger ◽

Ulrike Nienaber ◽

Rolf Lefering ◽

Maximilian Braun ◽

Arasch Wafaisade ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Glasgow Coma Scale ◽

Pediatric Traumatic Brain Injury ◽

Coma Scale

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Relationship of The Degree of Head Injury Based on Glasgow Coma Scale (GCS) with the Arrival of Acute Post Concussion Syndrome (PCS) Onset in Post-Head Injury Patients in General Hospital Dr.M.Djamil Padang

Biomedical Journal of Indonesia: Jurnal Biomedik Fakultas Kedokteran Universitas Sriwijaya ◽

10.32539/bji.v7i1.273 ◽

2021 ◽

Vol 7 (1) ◽

pp. 153-169

Author(s):

Muhammad Reza Azriyantha ◽

Syaiful Saanin ◽

Hesty Lidya Ningsih

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Glasgow Coma Scale ◽

Cause Of Death ◽

Head Injuries ◽

Acute Onset ◽

P Value ◽

Coma Scale ◽

Post Concussion Syndrome

A B S T R A C TBackground: Traumatic brain injury is the main cause of death in the populationunder the age of 45 years, and the fourth leading cause of death in the entire ofpopulation. Based on the degree of traumatic brain injury, it is commonly categorizedbased on the Glasgow Coma Scale (GCS). Post-Concussion Syndrome (PCS) is theset of somatic, emotional / behavioral and cognitive symptoms that occur after atraumatic brain injury. The aim of this study was to find out the prevalence andcorrelation of the degree of traumatic brain injury based on the Glasgow Coma Scale(GCS) and the emersion of Post-Concussion Syndrome (PCS) acute onset in patientswith head injuries Method: This study was a cross-sectional analytic study ofpatients who experienced Post-Concussion Syndrome (PCS) after traumatic braininjury at DR. M. Djamil Hospital Padang in 2020 from June to November 2020. Datawere collected by filling in a questionnaire (The Rivermead Post ConcussionSymptoms Questionnaire) and medical record data of neurosurgical patients thatmet the inclusion and exclusion criteria. Result: : It indicated that 70 patients wereincluded in the inclusion criteria of this study. A total of 38 (54.3) respondents didnot undergo the acute onset of PCS, meanwhile respondents who experienced acuteonset of PCS were 32 (45.7) respondents. The results showed that 25 (67.6%)respondents with mild traumatic brain injury had PCS acute onset, while 4 (17.4%)respondents with moderate degree of traumatic brain injury had PCS acute onset,and 4 (17.4%) respondents had PCS acute onset PCS 3 (30%) respondentsexperienced severe traumatic brain injury with acute onset PCS and statistically thedifference in the proportion of data from each of these variables was significant witha p-value of 0.0001. The results of statistical tests showed that p value> 0.05 on thecorrelation between PCS and GCS, thus, it can be concluded that there was nocorrelation between the direction of the relationship between PCS and GCS.Conclusion There was no correlation between the degree of traumatic brain injurybased on GCS and the incidence of PCS acute onset, either it was unidirectional orvice versa in patients with head injuries at RSUP M. Djamil Padang.

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Pre-Hospital and Trauma Center Glasgow Coma Scale Scores Are Frequently Discordant in Pediatric Traumatic Brain Injury Patients

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2017.07.896 ◽

2017 ◽

Vol 225 (4) ◽

pp. e137

Author(s):

Joseph D. Drews ◽

Junxin Shi ◽

Krista K. Wheeler ◽

Eric A. Sribnick ◽

Rajan K. Thakkar

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Glasgow Coma Scale ◽

Trauma Center ◽

Pediatric Traumatic Brain Injury ◽

Coma Scale ◽

Scale Scores

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Epidemiology of Pediatric Traumatic Brain Injury at Sylvanus Olympio University Hospital of Lomé in Togo

Anesthesiology Research and Practice ◽

10.1155/2019/4038319 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Pilakimwe Egbohou ◽

Tabana Mouzou ◽

Pikabalo Tchetike ◽

Hamza Doles Sama ◽

Sarakawabalo Assenouwe ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Traffic Accidents ◽

Brain Injuries ◽

Injury Severity ◽

Road Traffic ◽

Skull Fracture ◽

University Hospital ◽

Pediatric Traumatic Brain Injury ◽

The Mean

Introduction. Severe pediatric traumatic brain injury (pTBI) is a leading cause of disability and death in children worldwide. Children victims of pTBI are admitted to the Sylvanus Olympio University Hospital (SOUH) at the multipurpose Intensive Care Unit (ICU). We aimed in this study to describe the epidemiologic characteristics and outcomes of pTBI patients admitted in this ICU. Patients and Methods. This study was conducted at the ICU of SOUH of Lome. It was a retrospective study based on patients’ records from 0 to 15 years old admitted during the period from 1 January 2012 to 30 June 2018 (5 years and 6 months). Results. We recorded 91 pTBI included in the study. The mean age was 7.7 ± 4.3 years. The male predominated with 67.0%. Road traffic accidents were the most common cause (79.1%), followed by falls (19.8%). The average pediatric Glasgow Coma Scale (pGCS) was 6.6 ± 1.4, with a mean Injury Severity Score (ISS) of 23.1 ± 8.4. The most common brain injuries found in the CT scan were brain edema (72.9%), skull fracture (69.5%), and brain contusion (55.9%). The average duration under mechanical ventilation was 2.1 ± 2.9 days, and the mean ICU stay was 4.9 ± 4.4 days. Overall mortality was 31.9% (29 cases). Factors significantly associated (p<0.05) with death were hypotension (51.7%), anemia (43.1%), hyperthermia (46.7%), GCS < 6 (64%), and ISS > 20 (48.9%). Conclusion. pTBI mortality remains high in SOUH ICU. Factors associated with mortality were secondary systemic insults, worse GCS < 6, and ISS > 20.

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Comparative study of pattern of head injury in a rural community hospital and a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20195386 ◽

2019 ◽

Vol 6 (12) ◽

pp. 4272

Author(s):

Suhas Patil ◽

Tanweerul Huda ◽

Sheel C. Jain ◽

Bharati Pandya ◽

Ravinder Narang

Keyword(s):

Head Injury ◽

Glasgow Coma Scale ◽

Rural Community ◽

Road Traffic ◽

Tertiary Care Hospital ◽

Head Injuries ◽

Tertiary Care ◽

Care Hospital ◽

Coma Scale ◽

Significant Difference

Background: The objective of the study was to compare clinical patterns of head injuries in reference to the Glasgow coma scale including neurological examination and also to determine morbidity and mortality in head injury patients admitted to a nodal tertiary care hospital and a rural community hospital.Methods: This prospective study was done at the emergency department of Kasturba Hospital attached to Mahatma Gandhi Institute of Medical Sciences and Sushrut Hospital, Maharashtra on a total of 1000 cases during one-year study duration. The severity of the head injury was analysed using a Glasgow coma scale and outcome in terms of management and death was assessed.Results: Out of 1000 cases with head injuries, 900 cases were admitted in tertiary care hospital and 100 cases in a rural hospital. A significant difference was observed in terms of age group (p=0.01), mode of trauma (p=0.04) and symptoms (p=0.03) among the patients admitted with head injuries in both hospitals. The mortality rate was 1% and 3% in tertiary care and rural hospitals respectively.Conclusions: Head injuries are predominantly affecting the male population and most of them are due to road traffic accidents. Early assistance of medical aid and emergency room care results in good outcomes with minimal deaths.

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