Are boys and girls that different? An analysis of traumatic brain injury in children

Abstract

IntroductionThe Phillips Report on traumatic brain injury (TBI) in Ireland found that injury was more frequent in men and that gender differences were present in childhood. This study determined when gender differences emerge and examined the effect of gender on the mechanism of injury, injury type and severity and outcome.MethodsA national prospective, observational study was conducted over a 2-year period. All patients under 17 years of age referred to a neurosurgical service following TBI were included. Data on patient demographics, events surrounding injury, injury type and severity, patient management and outcome were collected from ‘on-call’ logbooks and neurosurgical admissions records.Results342 patients were included. Falls were the leading cause of injury for both sexes. Boys’ injuries tended to involve greater energy transfer and involved more risk-prone behaviour resulting in a higher rate of other (non-brain) injury and a higher mortality rate. Intentional injury occurred only in boys. While injury severity was similar for boys and girls, significant gender differences in injury type were present; extradural haematomas were significantly higher in boys (p=0.014) and subdural haematomas were significantly higher in girls (p=0.011). Mortality was 1.8% for girls and 4.3% for boys.ConclusionsFalls were responsible for most TBI, the home is the most common place of injury and non-operable TBI was common. These findings relate to all children. Significant gender differences exist from infancy. Boys sustained injuries associated with a greater energy transfer, were less likely to use protective devices and more likely to be injured deliberately. This results in a different pattern of injury, higher levels of associated injury and a higher mortality rate.

Pattern and Outcome of Pediatric Traumatic Brain Injury at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia: Observational Cross-Sectional Study

“…is finding is in agreement with Nigerian, South African, and Tunisian studies. is could be related to boy's risk-prone behavior resulting in high energy transfer and their outdoor engagement [14,30,[34][35][36][37]. Concerning mechanisms of injury, unintentional pedestrian RTA and falls were the most common causes followed by intentional fights/violence injuries.…”

Social dysfunction after pediatric traumatic brain injury: A translational perspective

“…In addition, many neuroanatomical regions involved in social cognition are sexually dimorphic, including septal and hypothalamic nuclei, and components of the circuitry involved in behavioral motivation (Kim et al, 2015; Shah et al, 2004). The degree to which these sexual distinctions influence behavioral outcomes after TBI is uncertain, although there is evidence of differential psychosocial and communication problems in male versus female patients (Despins et al, 2015; Gerring et al, 2002; Moreno and McKerral, 2015; Scott et al, 2015), even in young children (Collins et al, 2013; Kaldoja and Kolk, 2015). Further studies are needed in this arena, as sex differences in how the developing brain responds to pTBI may have important implications for both diagnosis and treatment after pTBI.…”

Prevention counseling among pediatric patients presenting with unintentional injuries to physicians' offices' in the United States

“…For example, expectations and assumptions that boys should or will engage in more risk-taking behavior than girls can result in boys actually engaging in more risk-taking behavior. Additionally, Collins et al (2013) found that boys age 0-17 years were more likely to engage in high intensity risk-taking behaviors and less likely to use protective equipment during these behaviors compared to girls. Motivation for engaging in such behaviors without the use of protection equipment may stem from the perception that "boys are tough," and should ignore the ramifications of injury.…”