LETTER TO THE EDITOR
|Year : 2011 | Volume
| Issue : 1 | Page : 97-98
Pediatric head injury: An epidemiological study
Pranshu Bhargava, Rahul Singh, Bhanu Prakash, Rohan Sinha
Department of Neurosurgery, PGIMER, Chandigarh, India
|Date of Web Publication||2-Sep-2011|
Assistant Professor, Department of Neurosurgery, Christian Medical College, Ludhiana, Punjab - 141008
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bhargava P, Singh R, Prakash B, Sinha R. Pediatric head injury: An epidemiological study. J Pediatr Neurosci 2011;6:97-8
In India, children between 1 and 15 years form about 35% of the total population.  Head Injury in infancy and childhood has been documented as the single most common cause of death.  Moreover, the modes of injury, the mechanisms of damage, and the management of specific problems differ significantly between the adult and pediatric populations.
This study was done to analyse the epidemiology of pediatric head injury in relation to age distribution, sex, mode of injury, and types of injuries.
This study includes 200 consecutive children aged 12 or less reporting to the Neurosurgical emergency of our institute. The management was done as per department protocol. All details pertaining to the study were noted as per set proforma. It included age, sex, mode of injury, GCS at arrival and discharge, outcome, CT scan findings, clinical findings, and presence or absence of seizure. The data were tabulated and analyzed.
Amongst the 200 patients aged 12 years or less, there were 123 males and 77 females (M:F = 1.59). Infants were only 13; 105 children in the age group of 1-5 years and 82 children between 5 and 12 years. The age distribution is shown in [Table 1].
The most common mode of injury was fall from height (unprotected rooftops while playing) seen in 56.5% of patients, followed by road traffic accident (being hit by a moving vehicle), accounting for 21% of injuries. Other modes were simple falls from chair or bed (17.5 %) and falling of heavy objects on the head. Graphic representation is shown in [Figure 1]. Seizure was seen in 10% of the patients.
The most common lesion found on CT scan was an extradural hematoma, which was seen in 33 (16.5%) patients. About half of these (15) needed evacuation. Cerebral contusion was seen in 15% of the patients, the frontal lobe being the most common site. Other lesions are shown in [Table 2].
Various studies on pediatric head injury have confirmed a male preponderance (59-71 % of cases). ,,, However, Sambasivan  has reported an equal number of males and females in his series on pediatric head injury. Fall from height has been cited by most studies as the most common cause of pediatric head injury. ,,,,, This is followed by road accidents, assaults, sports injuries, and various other mechanisms like coconut injury. 
Our results are in accordance showing fall from height as the most common cause of pediatric head injury. This peculiarly occurs from unguarded rooftops while the child is playing. However, Osmond  from Canada cites motor accidents as the most common cause. The most common lesion seen on CT scan was an EDH, whereas Mahapatra reports contusion as the most common. Seizure was seen in 10% of our patients; a similar incidence has been reported by others also.  Mortality was 10% and limited to patients of severe head injury only. A mortality of 20-50% has been reported for severe head injury. 
Falls form the most important cause of pediatric head injury and slight carefulness on the part of parents can help avoid disastrous consequences for the children.
| References|| |
|1.||NFHSZ, India 1998 - 9. International Institute for population studies, Mumbai, India. |
|2.||Luerssen TG, Klauber MR, Marshall LF. Outcome from head injury related to patient's age: A longitudinal prospective study of adult and pediatric head injury. J Neurosurg 1988;68:409-16. |
|3.||Crankson SJ. Motor vehicle injuries in childhood: A hospital based study in Saudi Arabia. Pediatr Surg Int 2006;22:641-5. |
|4.||Osmond MH, Brennan-Barnes M, Shephard AL. A 4- year review of severe pediatric trauma in eastern Ontario: a descriptive analysis. J Trauma 2002:52:8-12. |
|5.||Lalloo R, vanAs AB. Profile of children with head injuries treated at the trauma unit of red cross. S Afr Med J 2004;94:544-6. |
|6.||Mahapatra AK. Head injury in children. In: Mahapatra AK, Kamal R, editor. A Text Book of head Injury. Delhi: Modern Publ 2004. p. 156-70. |
|7.||Sambasivan M. Epidemeology-Pediatric head injuries. Neurol India 1995;43:57-8. |
|8.||Jennet B. Epidemeology of head injury. Arch Dis Child 1998:78:403-6. |
|9.||Hahn YS, Fuchs S, Flannery AM, Barthel MJ, McLone DG. Factors influencing posttraumatic seizures in children. Neurosurgery 1988;22:864-7. |
[Table 1], [Table 2]