PEDIATRIC HEAD TRAUMA: A DESCRIPTION OF CAUSES, NEUROLOGICAL MORBIDITY AND INPATIENT MORTALITY IN A REFERENCE CENTER IN NORTHEASTERN, BRAZIL

Quézia Mendonça Da Silva, I. Maldonado
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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.
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儿科头部创伤:在巴西东北部的参考中心的原因,神经系统发病率和住院病人死亡率的描述
头部创伤后遗症儿童的社会经济影响是一个重要的公共卫生问题。本回顾性研究评估了巴西东北部一家转诊中心住院期间儿童头部损伤的原因、神经系统发病率和死亡率。随机抽取282例儿童头部创伤病例12个月的医疗记录进行研究。检索患者特征、创伤机制和影像学结果,并评估整个住院期间运动障碍、语言障碍、脑脊液漏、癫痫发作或死亡的发生情况。受影响最大的年龄范围是婴儿(41.5%),最常见的报告原因是跌倒(76.5%),大多数儿童是轻度脑损伤(96%)的受害者。11.7%的ct检查显示为外伤性损伤,其中骨折占43.6%。13名儿童呈现上述发病率和死亡率终点。发作(n=9)是最常见的一种。发病率最高的年龄组也为婴儿(n=6)。对于相同的终点,整个系列的临床发病率-死亡率为4.6%,中度和重度创伤的临床发病率-死亡率为44.4%。住院期结束时的死亡率为1.1%。根据本研究的数据,跌倒是儿童头部创伤的主要报告原因。在住院期间,共有4.6%的受害者出现了神经系统的发病-死亡终点,癫痫发作是最常见的。
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