Evaluation of Head On Computed Tomography Among Paediatric Patients Presenting with Trauma: Paediatric Patients Presenting with Trauma

Arooj  Ansar; Akash  John; Abid  Ali; Aiman  Zafar; Zainab  Saghir; Ali  Junaid Dar

doi:10.54393/pbmj.v5i12.834

Authors

Arooj Ansar University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Gujrat Campus, Pakistan
Akash John University Institute of Radiological Sciences and Medical Imaging Technology, The University of Chenab, Gujrat, Pakistan
Abid Ali Department of Allied Health Sciences, The University of Chenab, Gujrat, Pakistan
Aiman Zafar University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Gujrat Campus, Pakistan
Zainab Saghir University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Gujrat Campus, Pakistan
Ali Junaid Dar University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Gujrat Campus, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v5i12.834

Keywords:

Head, Trauma, Paediatric,Computed Tomography (CT), Skull

Abstract

Unintentional falls from heights are one of the leading causes of mortality and permanent brain and bone damage in children. Objective: To evaluate the causes, symptoms, and findings of paediatric head trauma using Computed Tomography. Methods: It was a descriptive cross-sectional study conducted at Aziz Bhatti Teaching Hospital, Gujrat. The data was collected from October 2022 to December 2022 for the duration of 4 months. A sample size of 120 patients has been calculated via a convenient sampling technique using a mean approach from previous related articles. Patients with falls from height in paediatric age 0-12 were included in the study while children elder than 12 were excluded from the study. The equipment used for the study was CT scan machine-64 helical. The data were entered and analyzed with the help of SPSS version 20.0. Results: Out of 120 patients, most of the patients were in the age group of >1-5years 72(60.0%), 78(65.0%) patients were male while females were 42(35.0%). The most common finding on CT with a history of falls from height is noted to be skull fracture 51(42.5%). 84(70.0%) patients fall from the height of >6 and <15feet and the most common clinical finding in patients was pain 52(43.3%), followed by bleeding 41(34.2%). Conclusion: In conclusion, most of children between the age of 1-5years experience fall from a height of >6 feet to <15feet. Skull fracture is the most common diagnosis. CT is an accurate and reliable tool for diagnosing injuries in patients who fall from heights.

References

Pérez-Suárez E, Jiménez-García R, Iglesias-Bouzas M, Serrano A, Porto-Abad R, Casado-Flores J. Falls from heights in Pediatrics. Epidemiology and evolution of 54 patients. Medicina Intensiva. 2012 Mar; 36(2): 89-94. doi: 10.1016/j.medine.2012.04.001

Sharma M, Lahoti BK, Khandelwal G, Mathur RK, Sharma SS, Laddha A. Epidemiological trends of pediatric trauma: A single-center study of 791 patients. Journal of Indian Association of Pediatric Surgeons. 2011 Jul; 16(3): 88-92. doi: 10.4103/0971-9261.83484

Sun Q, Shi Y, Zhang F. Pediatric skull fractures and intracranial injuries. Experimental and therapeutic medicine. 2017 Sep; 14(3): 1871-4. doi: 10.3892/etm.2017.4715

Ganau M and Fehlings MG. Clinical and health policy-related challenges of pediatric spinal cord injuries. Neurology India. 2017 May; 65(3): 475. doi: 10.4103/neuroindia.NI_315_17

Garg K, Sharma R, Gupta D, Sinha S, Satyarthee GD, Agarwal D, et al. Outcome predictors in pediatric head trauma: A study of clinicoradiological factors. Journal of pediatric neurosciences. 2017 Apr; 12(2): 149-53. doi: 10.4103/jpn.JPN_179_16

Jordan BD. The clinical spectrum of sport-related traumatic brain injury. Nature Reviews Neurology. 2013 Apr; 9(4): 222-30. doi: 10.1038/nrneurol.2013.33

Lerner EB, Shah MN, Cushman JT, Swor RA, Guse CE, Brasel K, et al. Does mechanism of injury predict trauma center need?. Prehospital emergency care. 2011 Aug; 15(4): 518-25. doi: 10.3109/10903127.2011.598617

Araki T, Yokota H, Morita A. Pediatric traumatic brain injury: characteristic features, diagnosis, and management. Neurologia medico-chirurgica. 2017; 57(2): 82-93. doi: 10.2176/nmc.ra.2016-0191

Stewart MT. Clinical features and management of children with toddler's fracture or suspected toddler's fracture in the pediatric emergency department (PED). In2012 AAP National Conference and Exhibition 2012 Oct.

Bowers CA, Riva-Cambrin JA, Hertzler DA, Walker ML. Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury. Journal of Neurosurgery: Pediatrics. 2013 May; 11(5): 526-32. doi: 10.3171/2013.1.PEDS12483

Chaudhary S, Figueroa J, Shaikh S, Mays EW, Bayakly R, Javed M, et al. Pediatric falls ages 0-4: understanding demographics, mechanisms, and injury severities. Injury epidemiology. 2018 Apr; 5(1): 77-87. doi: 10.1186/s40621-018-0147-x

Lerwick JL. Minimizing pediatric healthcare-induced anxiety and trauma. World journal of clinical pediatrics. 2016 May 8; 5(2): 143-50. doi: 10.5409/wjcp.v5.i2.143

Tavarez MM, Atabaki SM, Teach SJ. Acute evaluation of pediatric patients with minor traumatic brain injury. Current opinion in pediatrics. 2012 Jun; 24(3): 307-13. doi: 10.1097/MOP.0b013e3283531ce6

Babu A, Rattan A, Ranjan P, Singhal M, Gupta A, Kumar S, et al. Are falls more common than road traffic accidents in pediatric trauma? Experience from a Level 1 trauma centre in New Delhi, India. Chinese journal of traumatology. 2016 Apr; 19(2): 75-8. doi: 10.1016/j.cjtee.2015.10.004

Hale AT, Stonko DP, Brown A, Lim J, Voce DJ, Gannon SR, et al. Machine-learning analysis outperforms conventional statistical models and CT classification systems in predicting 6-month outcomes in pediatric patients sustaining traumatic brain injury. Neurosurgical focus. 2018 Nov; 45(5): 1-7. doi: 10.3171/2018.8.FOCUS17773

Dara PK, Parakh M, Choudhary S, Jangid H, Kumari P, Khichar S. Clinico-radiologic profile of pediatric traumatic brain injury in Western Rajasthan. Journal of Neurosciences in Rural Practice. 2018 Apr; 9(02): 226-31. doi: 10.4103/jnrp.jnrp_269_17

Karmacharya BG, Acharya B. Pediatric head injuries in a neurosurgery center of Nepal: an epidemiological perspective. American Journal of Public Health Research. 2015 Jun; 3: 76-9.

Tunthanathip T, Phuenpathom N. Impact of road traffic injury to pediatric traumatic brain injury in Southern Thailand. Journal of neurosciences in rural practice. 2017 Oct; 8(04): 601-8. doi: 10.4103/jnrp.jnrp_381_17

John SM, Jones P, Kelly P, Vincent A. Fatal pediatric head injuries: a 20-year review of cases through the Auckland coroner's office. The American Journal of Forensic Medicine and Pathology. 2013 Sep; 34(3): 277-82. doi: 10.1097/PAF.0b013e3182a187e9

Iobst CA, Spurdle C, Baitner AC, King WF, Tidwell M, Swirsky S. A protocol for the management of pediatric type I open fractures. Journal of Children's Orthopaedics. 2014 Feb; 8(1): 71-6. doi: 10.1007/s11832-014-0554-7

Rabiu TB and Ogundipe H. Profile of Pediatric Traumatic Brain Injury in South-West Nigeria. World neurosurgery. 2022 Oct; 166: e711-20. doi: 10.1016/j.wneu.2022.07.078

Hung KL. Pediatric abusive head trauma. biomedical journal. 2020 Jun; 43(3): 240-50. doi: 10.1016/j.bj.2020.03.008

Sarkar K, Keachie K, Nguyen U, Muizelaar JP, Zwienenberg-Lee M, Shahlaie K. Computed tomography characteristics in pediatric versus adult traumatic brain injury. Journal of Neurosurgery: Pediatrics. 2014 Mar; 13(3): 307-14. doi: 10.3171/2013.12.PEDS13223

Işık HS, Gökyar A, Yıldız Ö, Bostancı U, Özdemir C. Pediatric head injuries, retrospective analysis of 851 patients: an epidemiological study. Turkish Journal of Trauma and Emergency Surgery. 2011 Mar; 17(2): 166-72. doi: 10.5505/tjtes.2011.22800

Chabok SY, Kapourchali SR, Leili EK, Saberi A, Mohtasham-Amiri Z. Effective factors on linguistic disorder during acute phase following traumatic brain injury in adults. Neuropsychologia. 2012 Jun; 50(7): 1444-50. doi: 10.1016/j.neuropsychologia.2012.02.029

Joyce T, Huecker MR. Pediatric Abusive Head Trauma (Shaken Baby Syndrome). Calio search. 2018.