Pediatric Head Injuries Occur During the Play Childhood Period of 3-6 Years: A Sample from the South of Türkiye

Yıl 2024, Cilt: 6 Sayı: 3, 329 - 334, 24.09.2024

Mustafa Oguz Cumaoglu , Abdussamed Vural , Mustafa Doğan , Burak Yuruk Mustafa Özçelik , Sabri Sekme

https://doi.org/10.37990/medr.1488845

Öz

Aim: Pediatric head traumas (HT) are of significant concern due to their potential for high mortality rates, which are influenced by the clinical progression of traumatic brain injury (TBI). HT poses a substantial risk of morbidity and mortality across all pediatric age groups, underscoring the importance of effective clinical management and follow-up procedures. The current study aims to evaluate the epidemiology, causes, and clinical outcomes of head injuries during childhood play between the ages of 3 and 6.
Material and Method: Focused on pediatric patients aged 3-6 years who were admitted to the emergency department (ED) for HT, and required consultation from a neurosurgeon. Data collected included patients’ demographics, trauma etiology, cranial examination findings, laboratory results upon admission, cranial computed tomography findings, classification of TBI, treatment administered, and clinical progression.
Results: The median Glasgow Coma Scale (GCS) scores were found to be significantly lower in the group with intraparenchymal injury compared to the group without intraparenchymal injury (p=0.008). The group with intraparenchymal injury exhibited a higher than expected occurrence of moderate TBI (p=0.012). Females exhibited significantly lower mean rank scores for age compared to males (p=0.032). Patients hospitalized for HT had significantly lower GCS scores than those discharged (p=0.001). There is a higher prevalence of moderate TBI than expected in the group of hospitalized patients (p=0.008). The mortality rate among hospitalized patients was 5.6%, with lower GCS scores and hyperglycemia upon admission significantly associated with fatalities (p=0.015, p=0.045).
Conclusion: Identification and management of moderate TBI are imperative in children presenting to the ED with HT during early childhood play. Children with intraparenchymal injury should be hospitalized. Additionally, hyperglycemia in pediatric HT patients may signify high-energy trauma.

Anahtar Kelimeler

Pediatric, head trauma, emergency department, neurosurgery, hyperglycemia

Etik Beyan

The study protocol was approved by Non-Interventional Ethics Committee of Niğde Ömer Halisdemir University, Faculty of Medicine (14.12.2023, No:2023/98).

Destekleyen Kurum

None

Kaynakça

• Chong SL, Barbier S, Liu N, et al. Predictors for moderate to severe paediatric head injury derived from a surveillance registry in the emergency department. Injury. 2015;46:1270-4.
• Neumane S, Câmara-Costa H, Francillette L, et al. Functional outcome after severe childhood traumatic brain injury: Results of the TGE prospective longitudinal study. Ann Phys Rehabil Med. 2021;64:101375.
• Amaranath JE, Ramanan M, Reagh J, et al. Epidemiology of traumatic head injury from a major paediatric trauma centre in New South Wales, Australia. ANZ J Surg. 2014;84:424-8.
• Satapathy MC, Dash D, Mishra SS, et al. Spectrum and outcome of traumatic brain injury in children <15 years: A tertiary level experience in India. Int J Crit Illn Inj Sci. 2016;6:16-20.
• Dewan MC, Mummareddy N, Wellons JC 3rd, Bonfield CM. Epidemiology of global pediatric traumatic brain injury: qualitative review. World Neurosurg. 2016;91:497-509.e1.
• Gelineau-Morel RN, Zinkus TP, Le Pichon JB. Pediatric head trauma: a review and update. Pediatr Rev. 2019;40:468-81.
• Chen C, Peng J, Sribnick EA, et al. Trend of age-adjusted rates of pediatric traumatic brain injury in U.S. emergency departments from 2006 to 2013. Int J Environ Res Public Health. 2018;15:1171.
• Letelier A, Watt RG, Heilmann A. Head injuries in early childhood in the UK; is there a social gradient?. J Epidemiol Community Health. 2022;76:600-5.
• Spencer NJ, Ludvigsson J, Bai G, et al. Social gradients in ADHD by household income and maternal education exposure during early childhood: Findings from birth cohort studies across six countries. PLoS One. 2022;17:e0264709.
• Ruffini C, Osmani F, Bigozzi L, Pecini C. Semantic fluency in 3-6 years old preschoolers: which executive functions?. Child Neuropsychol. 2024;30:563-81.
• Marques PDN, Oliveira RM, Correa J. Contributions of executive functions and linguistic skills to verbal fluency in children. Child Neuropsychol. 2022;28:1031-51.
• Haydel MJ, Weisbrod LJ, Saeed W. Pediatric Head Trauma. In: StatPearls. Treasure Island (FL): StatPearls Publishing; November 12, 2022.
• Mihić J, Rotim K, Marcikić M, Smiljanić D. Head injury in children. Acta Clin Croat. 2011;50:539-48.
• Yang ZQ, Zhang QM. Rehabilitation care for children after trauma in the earthquake disaster. Zhongguo Dang Dai Er Ke Za Zhi. 2013;15:431-4.
• Burns EC, Grool AM, Klassen TP, et al. Scalp hematoma characteristics associated with intracranial injury in pediatric minor head injury. Acad Emerg Med. 2016;23:576-83.
• Hansen JB, Killough EF, Moffatt ME, Knapp JF. Retinal hemorrhages: abusive head trauma or not?. Pediatr Emerg Care. 2018;34:665-70.
• Blackwell CD, Gorelick M, Holmes JF, et al. Pediatric head trauma: changes in use of computed tomography in emergency departments in the United States over time. Ann Emerg Med. 2007;49:320-4.
• Dolanbay T, Gül HF, Şimşek AT, Aras M. Severe traumatic brain injury cases among children younger than 24 months. Pediatr Neurosurg. 2020;55:12-6.
• Karasu A, Sabanci PA, Cansever T, et al. Epidemiological study in head injury patients. Ulus Travma Acil Cerrahi Derg. 2009;15:159-63.
• Schunk JE, Schutzman SA. Pediatric head injury. Pediatr Rev. 2012;33:398-411.
• Tavor O, Boddu S, Kulkarni AV. Presenting characteristics of children who required neurosurgical intervention for head injury. Childs Nerv Syst. 2016;32:827-31.
• Hung KL. Pediatric abusive head trauma. Biomed J. 2020;43:240-50.
• Hamilton M, Mrazik M, Johnson DW. Incidence of delayed intracranial hemorrhage in children after uncomplicated minor head injuries. Pediatrics. 2010;126:e33-9.
• Chen S, Liu Z. Effect of hyperglycemia on all-cause mortality from pediatric brain injury: a systematic review and meta-analysis. Medicine (Baltimore). 2020;99:e23307.
• Bowman SM, Bird TM, Aitken ME, Tilford JM. Trends in hospitalizations associated with pediatric traumatic brain injuries. Pediatrics. 2008;122:988-93.
• Scaife ER, Statler KD. Traumatic brain injury: preferred methods and targets for resuscitation. Curr Opin Pediatr. 2010;22:339-45.