Dara PK, Parakh M, Choudhary S, Jangid H, Kumari P, Khichar S. Clinico-radiologic Profile of Pediatric Traumatic Brain Injury in Western Rajasthan.
J Neurosci Rural Pract 2019;
9:226-231. [PMID:
29725174 PMCID:
PMC5912029 DOI:
10.4103/jnrp.jnrp_269_17]
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Abstract
Objective:
The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI).
Design:
Prospective observational study
Setting:
Intensive Care Unit, ward and OPD of Pediatrics, Dr. S. N. Medical College, Jodhpur (tertiary care hospital).
Participants:
A total of 188 children (1 month–18 years) were enrolled and 108 admitted.
Intervention:
TBI classified as mild, moderate, or severe TBI. Neuroimaging was done and managed as per protocol. Demographic profile, mode of transport, and injury were recorded.
Outcome:
Measured as hospital stay duration, focal deficits, mortality, and effect of early physiotherapy.
Results:
Males slightly outnumbered females mean age was 5.41 ± 4.20 years. Fall from height was the main cause of TBI (61.11%) followed by road traffic accident (RTA) (27.78%). Majority (56.56%) reached hospital within 6 h of injury, out of which 27% of patients were unconscious. Mild, moderate, and severe grade of TBI was seen in 50%, 27.78%, and 22.22% of cases, respectively. About 12.96% of cases required ventilator support. The average duration of hospital stay was 11.81 ± 12.9 days and was lesser when physiotherapy and rehabilitation were started early. In all children with temporal bone fracture, magnetic resonance imaging (MRI) brain revealed a temporal lobe hematoma and contusion in spite of initial computed tomography (CT) head normal. Children who have cerebrospinal fluid (CSF) rhinorrhea/otorrhea had a high chance of fracture of base of skull and contusion of the basal part of the brain.
Conclusion:
In India, fall from height is common setting for pediatric TBI besides RTA. Early initiation of physiotherapy results in good outcome. MRI detects basal brain contusions in children presenting with CSF rhinorrhea/otorrhea even if initial CT brain is normal.
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