Traumatic brain Injuries among children - a retrospective study

Abstract

Introduction. Traumatic brain injury (TBI) is the leading cause of disability and death in children and adolescents, with approximately 5 in 1,000 children experiencing a TBI each year and 1 in 30 children suffering a TBI by age 16 years. TBI in children result in a range of traumatic injuries to the scalp, skull, and brain that are comparable to those in adults but differ in both pathophysiology and management. The differences are attributable to age-related structural change, mechanism of injuries based on physical ability of the child, and the difficulty in neurological evaluation of pediatric populations. The aim of this study was to explore the particularities of TBI among children in the Republic of Moldova. Material and methods. A retrospective study was conducted among children patients with TBI at the Municipal Children’s Hospital Valentin Ignatenco - a tertiary medical institution for emergency health care. It was applied a questionnaire, completed on the basis of.ifledical records according to ICD10 codes. The collection period was August, 1 - October, 31, 2018. The data were uploading using the existing electronic data collection tool - Red Cap and analyzed trough Microsoft Excel. Data collection was performed by a resident neurosurgery and a scientific researcher. The ethics committee's approval has been obtained. Results. There have been identified 56 cases of TBI in children aged between 0- 17 years old, of which 22,6% male and 14,6% female; most cases being in the age group 0-6 years old (48,3%), followed by group of 10-14 years old (21,4%). In more than half of cases, injury appears in urban area, 32,1% in group of 0-6 years old, of the remaining cases in the rural area 30,3%. The major cause of the intracranial injuries was through falls (64,3%), the most affected group being 0-6 years old (13, 8%). On the second place there were road accidents (26,8%) with the most cases in the age group of 0-6 and 15-17 years old (8,9%), followed by assault/violence (8,9%). More than injury occurred at home (39,3%), followed by recreation area (10,7%), transport area (8,9%). Less than 1/2 of the cases were registered in August 39,3%, between 10.00- 14.00 (42,2%), 20.00-06.00 (19,6%). Conclusion. Among children, the most vulnerable age of TBI were from 0-6 years old and 10-14 years old, and most TBI are caused at home as a result of falls and recreational and playgrounds, followed by road accidents. The results of the study impose to develop prevention measurements for this target group.