Aetiological Patterns and Management Outcome of Paediatric Head Trauma: One-year Prospective Study

Abstract

Trauma is themost common cause of paediatric deaths. In75% of paediatric trauma deaths, head injury is responsible, and most are from falls. Recent reports from Nigeria, however, appear to indicate a predominance of road traffic accidents, instead of falls. To evaluate the aetiology of paediatric head trauma, management protocols and outcome from our Centre, in order to acquire a baseline data base and recommendmeasures to reduce childhood trauma. Aprospective study of all paediatric head trauma cases presenting toNnamdiAzikiwe University Teaching Hospital, Nnewi, for 12months from April 21, 2006 to April 20, 2007, was done and collated data subsequently analyzed. The paediatric age group was taken as =15years, and grading of head injurywaswith theGlasgowComa Scale (3 15) and themodified scale for non-verbal children;while outcome wasmeasuredwith the Glasgow Outcome Scale (1 5). Out of 334 patients treated within the period of study, 210 were head trauma cases. Of these, 52 were paediatric head trauma, representing 24.8% of all head trauma cases; and 19.2% (10 of 52) of them were aged 0- 2years. About 62%(32 of 52) were males. Falls and RTA were each responsible in 25(48.1%) cases. Mild head injury occurred in 31(59.6%), and 49(94.2%) patients were evaluated by plain radiography. Treatment was conservative in 39(75%) cases;with satisfactory outcome in 36(69.2%), and amortality rate of 15.4%. Road traffic injury, mostly from motorcycles, has become the major cause of morbidity and mortality amongst the paediatric age group, especially the male gender, and outcome from management is mostly satisfactory.

Keywords: Head injury,Motorcycle,Road,Radiography,Traffic