Introduction:Traumatic brain injury (TBI) in children is a significant cause of morbidity and mortality worldwide. Falls are the most common type of injury, followed by motor vehicle-related accidents and child abuse.Aims and Objectives:The aim and objective of this study was to elucidate the various modes of injury, prognostic factors, complications, incidence of various modes of injury, and outcome in TBI in pediatric population.Materials and Methods:Patients with TBI, 18 years or less in age, managed in our Department of Neurosurgery, over a period of 2 years, were studied prospectively. Detailed history, general physical examination, systemic examination, and central nervous system examination including assessment of Glasgow Coma Scale score (GCS) and pupillary size and reaction were noted in every patient. Based on GCS, patients were divided into mild head injury (GCS 13–15), moderate head injury (GCS 9–12), and severe head injury (GCS ≤8) categories. All the patients were subjected to plain computed tomography (CT) scan head, and CT findings were noted. Patients were managed conservatively or surgically as per the standard indications. The outcome of all these patients was assessed by Glasgow outcome scale and divided into good (normal, moderate disability) and poor (severe, vegetative, dead) outcome. Outcome was assessed in relation to age, sex, GCS, pupil size and reaction, CT scan features, intervention, and associated injuries.Results:A total of 403 patients aged between 1 day and 18 years were included in the study comprising 252 males (63%) and 151 females (37.75%). The common modes of injury were fall 228 (56.6%) followed by road traffic accidents 138 (34.2%), assault 10 (2.5%), and others 27 (6.7%) which include sports injury, hit by some object on head, and firearm injury. Majority of our patients had a GCS of 13–15 (mild head injury), 229 (57.3%), followed by 9–12 (moderate head injury) 119 (29.8%), followed by 8 or less (severe head injury) 52 (13%). In group of patients in the category of GCS ≤ 8, poor outcome was seen in 65.3%, followed by patients in group GCS 9–12 at 2.45% succeeded by group of patients with GCS 13–15 at 2.6%, which was statistically significant (P < 0.0001). A total of 354 (87.8%) patients had normal pupils, 37 (9.2%) had anisocoria, and 12 (3%) patients had fixed dilated pupils. Fixed dilated pupil had poor outcome (100%) followed by anisocoria (40.5%) and normal pupils (16%), which was statistically significant (P < 0.0001).Conclusion:Majority of children who suffer from TBI do well although it still continues to be a significant cause of morbidity and mortality in them. The outcome is directly related to the neurological status in which they present to the hospital.

Introduction: On 26 December 2003, a devastating earthquake destroyed Bam, a city in southeastern Iran. After this event, a database was provided by a large prospective multicenter, cross-sectional study, which recruited all injured patients who remained hospitalized in five different provinces of Iran one week after the earthquake. Objective: To determine the frequency of different types of bone fractures in hospitalized earthquake victims. Method: Pertinent data including gender, age, and specific types of radiologically proven bone fractures were extracted from the original database. Results: Of a total of 1,052 hospitalized earthquake victims, 484 (46.01%) were female and 568 (53.99%) were male. Collectively, 692 (65.8%) patients had radiologically proven fractures. The fractures were categorized into three groups. Those fractures affecting the long bones of upper and lower extremities were diagnosed in 395 cases (37.5% of the total cases). Pelvic fractures were detected in 264 cases (25.1% of the total cases), and vertebral fractures were found in 124 cases (11.8% of the total cases). A total of 91 patients were grouped in at least two of the three categories. Respectively, 348 (71.9%) and 344 (60.5%) of female and male patients had proven fractures, with mean ages of 28.9 and 29.9 years. Conclusion: Bone fractures accounted for one of the most common injuries in earthquake victims and were more prevalent in the long bones of extremities compared to the pelvis and spine. Females noticeably were more prone to sustain bone fractures than men, probably due to their lower bone density.