The Outcome of Severe Traumatic Brain Injury in Children in Qatar: Six year study

Abstract

Traumatic brain injuries (TBI) are important public health problem resulting in short-term or permanent disability and death. To determine the extent and outcome of severe TBI amongst children in Qatar medical records were reviewed retrospectively of all cases of severe TBI in children aged 14 years or less who attended the Children Rehabilitation Unit, Hamad General Hospital, Qatar, between January 2002 to December 2008. The severity of TBI was assessed by the Glasgow Coma Scale (GCS). Of 65 children with severe TBI, most were male (73.8 %) and 91 % were older than five years of age. The leading causes of injury were road traffic accident (84.6%) and falls (10.8%). Other causes included trauma by ceiling fan blades (4.6%), sports and recreation injuries. Early sequelae included spasticity (43.1 %) and posttraumatic epilepsy (33.8%); both were significantly associated with the increased severity and need for intracranial surgery. Almost a quarter of the children had communication disorders, 17 (26.2 %) had poor cognition, 16 (24.6%) had hemiplegia and 12 (18.5 %) had abnormal behaviour. Twelve (18.5%) children died within the first month of admission to hospital. It is clear that severe TBI results in significant morbidity and mortality among children in Qatar and special efforts are needed to reduce the causes especially motor vehicle crashes and injuries. Rehabilitation programs are also needed to limit the extent of long-term complications associated with TBI.