Traumatic brain injury in children: 18 years of management

Traumatic brain injury in children is a common cause of emergency department admission to our institution. The aim was to summarize the management of all head injuries in children. This was a retrospective, descriptive single center study performed in the Neurosurgery Department, University Hospital Center, Yopougon-Abidjan, Ivory Coast from January 2000 to December 2017. We included all patients less than 16-years-old admitted to the emergency department and all admitted in neurosurgery department for a traumatic brain injury with a cerebral tomodensitometry and/or a magnetic resonance imaging. 292 patients were admitted in neurosurgery department during the study period. The average age of our patients was 7.8 ± 0.80 years with a male predominance (64%). Road accidents were the main causes (78.7%) followed by falls. Brain trauma was mild in 53.8% of cases, moderate in 36.8% and severe in 9.4% of cases. Initial loss of consciousness and headache were the main reasons for admission to the emergency room after the injury with a proportion of 87.6%. The oedemato-haemorrhagic contusion was the most frequent lesion found in our patients with a frequency of 33.9%. The surgery was performed in 36.9% of cases. The overall mortality of patients in the study remains high with a proportion of 13.18%. Traumatic brain injuries in children had a high mortality rate in our practice. Specialized centers should be developed to optimize their care.