Paediatric head trauma: influence of age and sex

Abstract

A consecutive unselected series of 1812 children (up to 15 years old) admitted for head injuries over a period of 8.5 years was studied. The cases were divided up according to five categories of pathology: benign injury, extradural haematoma, subdural haematoma, open brain laceration and brain contusion in a broad sense. All cases of benign injury were from the Geneva area (57000 children) and 52% of the cases of severe injury were referred from other places. To these 1812 cases were added those of 23 children who died before admission recorded by the police. In the Geneva area the mortality was 6.8/100,000 per year. Patients were divided into three age groups: I (0-3 years), II (3-9 years), and III (9-15 years); group I was further subdivided into subgroups I a (0-1 year) and I b (1-3 years). The incidence of each type of accident was calculated for each age group, separately for girls and boys. Each type of pathology was correlated, sex by sex and for different ages, with the type of accident. Overall, two boys were injured for each girl. Road accidents were responsible for 15% of head injuries in group I girls, 17% in group I boys, 43% in group II girls, 45% in group II boys, 50% in group III boys and 61% in group III girls. They were responsible for 94% of all deaths and 85% of deaths of hospitalized patients. Falling was the most frequent cause of injury. Benign injuries were more frequent in group I. Only 1 of 25 patients with extradural haematomas died, and there were only 8 patients with subdural haematomas, 4 in subgroup I a (babies aged less than 1 year).

Gender and age effects on outcome after pediatric traumatic brain injury*

“…Many other authors have found a higher mortality rate in younger children (33, 50 -55), whereas only a few have shown no effect of age or lower mortality rate in infants (34,49). Reasons postulated for higher mortality rates in infants have included the more compliant skull as well as the higher incidence of nonaccidental trauma in this age group.…”

Postraumatic intracranial hematomas in infancy

“…This study of post-traumatic intracranial hematomas in infancy reveals that age and sex are closely related to the type and mechanism of injury causing CCT and to the probability of developing post-traumatic ICH, since girls showed a higher frequency among children under 3 years of age, and boys among those over 7 years of age [2,3,19]. Of the total population in this study, 73.5% were boys, coinciding with data published by other authors [4].…”

“…The majority of head injuries in childhood are not severe and have minor consequences. When the head injury is severe, however, the sequelae are important and reflect a high mortality rate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).5%) [1,2,4,5,9,14,15,24,27]. Analysis of the epidemiological aspects in this group of patients is important, since work in this field will contribute to the prevention of such injuries and a reduction in the number of cases.…”

Epidemiology of Traumatic Head Injury in Korean Children

“…In the case of children under the age of 2 yr, who have open anterior fontanelle and lack communication skills, previous studies have shown different mechanisms and clinical features, compared with children over the age of two (29, 30). Accordingly, there are several items that should be added in the examination of infants.…”