A Study on the Outcome of Pediatric Traumatic Brain Injuries in a Rural Tertiary Care Facility

Abstract

Background: Traumatic brain injuries are the leading cause of death and disability in children. Approximately 70%–80% of accidental deaths in the pediatric age group are directly attributable to injuries to the central nervous system. Purpose: To study the clinico-radiological outcome of traumatic brain injury in a pediatric population in a rural tertiary center. Materials and Methods: A total of 103 children with a diagnosis of traumatic brain injury who met the inclusion or exclusion criteria were considered for the study. Traumatic brain contusions, subdural hematoma, extradural hematoma (EDH), and skull fractures were treated either conservatively or surgically; accordingly, their Glasgow Coma Scale (GCS) at the time of initial presentation was compared with the GCS at discharge, and the cases were followed-up at 1 month and 3 months after discharge. Results: There were 56 males (54.37%) and 47 females (45.63%) with a male-to-female ratio of 81.19:1. The most common mode of injury was fall from height (n = 82, 79.61%), followed by road traffic accident (n = 20, 19.42%). The majority of patients presented with loss of consciousness (n = 76, 73.79%), followed by vomiting (n = 68, 66.02%) and ear nose throat bleeding. Mild traumatic brain injury with GCS = 13–15 was observed in 64 cases (62.14%); our series has a mortality of 1.94% (n = 2). A significant association between Glasgow Outcome Scale (GOS) and GCS was found in patients with fractures and EDH. A significant association between GOS and GCS was found in patients with contusions. Good recovery was more likely to be observed with higher GCS scores. GOS was significantly associated with GCS score on admission. Conclusion: The motility rate was 1.94% in the study population. Most patients had a GCS score of 13–15 with mild injuries. The outcome on radiological features such as fracture, EDH, and contusion was significantly associated with GCS score on admission.