Pediatric Head Trauma: A Description of Causes, Neurological Morbidity and Inpatient Mortality in a Reference Center in Northeastern, Brazil

Abstract

artigo Pediatric head trauma: a descriPtion of causes, neurological morbidity and inPatient mortality in a reference center in northeastern brazil TraumaTismo crânio-encefálico pediáTrico: causas, morbidade neurológica e morTalidade hospiTalar em um cenTro de referência do nordesTe do brasil abstract the socioeconomic impact of children with sequelae of head trauma is an important public health concern. this retrospective study assessed the causes, the neurological morbidity and the mortality of pediatric head injury during the hospital stays in a referral center in northeastern Brazil. a random sample of 282 medical records of pediatric head trauma cases from a twelve-month period was examined. Patient characteristics, mechanisms of trauma and imaging results were retrieved, and the occurrence of motor deficits, language impairment, cerebrospinal fluid leak seizures or death was assessed during the whole hospital stays. The most affected age range was that of infants (41.5%), the most frequent reported cause was fall (76.5%) and most children were victims of mild brain injury (96%). A total of 11.7% of the computerized tomography examinations showed traumatic injuries, with fractures in 43.6% of them. Thirteen children presented with the above-mentioned endpoints of morbidity and mortality. Seizure (n=9) was the most frequent one. The age range with the highest incidence was also that of infants (n=6). For the same endpoints, the clinical morbid-mortality was 4.6% for the wholes series and 44,4% for moderate and severe trauma. The mortality rate at the end of the period of hospitalization was 1.1%. According to the data from the present study, falls were the main reported cause of pediatric head trauma. A total of 4.6% of victims presented with neurological endpoints of morbid-mortality during the hospital stay and seizure was the most frequent one. resumo o impacto socioeconômico de crianças portadoras de sequelas de traumatismo crânio-encefálico (TCE) é um importante problema de saúde pública. Neste estudo retrospectivo, foram avaliadas as causas, a morbidade neurológica e a mortalidade do TCE pediátrico, durante o período de permanência hospitalar em um centro de referência no Nordeste do Brasil. Foi examinada uma amostra aleatória de 282 prontuários em um período de doze meses. As características das vítimas, os mecanismos de trauma e os resultados dos exames de imagem foram analisados. A ocorrência dos seguintes desfechos clínicos neurológicos foi contabilizada durante toda a internação, a saber: déficits motores, distúrbios de linguagem, convulsões, fístulas liquóricas clinicamente detectáveis ou morte. A faixa etária mais afetada foi a dos lactentes (41,5%), a causa mais frequentemente relatada foi queda (76,5%) e a maioria das crianças foi vítima de TCE leve (96%). Um total de 11,7% dos exames de tomografia computadorizada mostrava lesões traumáticas, com fraturas em 43,6% delas. Treze crianças apresentaram os desfechos clínicos de morbidade e mortalidade acima mencionados. A crise convulsiva (n=9) foi o...