Citation

Sase T, Oshio K, Takasuna H, Kaji T, Kono T, Uchida M, Matsumori T, Ito H, Tanaka Y. Neurotraumatol. 2019; 42(1): 35-38.

Copyright

(Copyright © 2019, Japan Society of Neurotraumatology)

DOI

10.32187/neurotraumatology.42.1_35

PMID

unavailable

Abstract

INTRODUCTION: To ascertain recent trends in pediatric head trauma, we analyzed patients who visited the emergency room-type critical care center and neurosurgery department at our hospital.Subject and Methods: We retrospectively analyzed 149 pedi­atric patients (≤15 years old) with head trauma hospitalized between January 2009 and September 2017.

RESULTS: Patients included 3 neonates, 34 infants, 44 pre­school children, 49 school children, and 19 adolescents (12-15 years old). Male-to-female ratio was 2:1. Most patients (118 patients, 79%) resided in Kawasaki City in northeastern Kanagawa Prefecture, where our hospital is located, while some (31 patients, 21%) visited or were transferred from outside the region serviced by our hospital. The most common mechanism of injury was a fall (91 patients, 61%), followed by traffic accident trauma (34 patients, 23%) and child abuse (9 patients, 6%). The most common route for hospitalization was ambulance (77 patients, 52%), followed by self-presentation to the night-time emergency center (57 patients, 38%) and general outpatient visit (15 patients, 10%). Fourteen patients (9%) underwent surgery, while the remaining 135 patients (91%) did not. Of the non-surgical cases, 76 patients (56%) presented with hemorrhagic lesions and 59 patients (44%) were hospitalized for observation of injuries such as cerebral concussion or skull fracture not in­volving intracranial hemorrhage. Surgical cases included acute-phase surgery in 11 patients (79%) and chronic-phase surgery in 3 patients (21%). Outcomes were satisfactory for all non-surgical cases. In surgical cases, outcomes were satisfactory in 9 patients (64%; good recovery, n=7 patients; moderate dis­ability, n=2 patients), and poor in 5 patients (36%; severely disabled, n=3 patients; persistent vegetative state, n=1 patient; dead, n=1 patient) including 3 patients with multiple traumas.

CONCLUSION: The prognosis for pediatric head trauma is considered relatively good. In our investigation, non-surgical cases accounted for most cases and showed satisfactory prog­nosis. However, the outcomes of severe cases requiring surgery were not always good. In our department, we plan to be pro­actively involved in severe cases in the nearby area as the last stronghold against severe pediatric head trauma.

Language: ja

Keywords

Pediatric head trauma