A Clinical Observation on Head Injuries in Infants and Children

Park, Chong Oon; Chae, Kweon Beong; Lee, Sang Don; Jeon, Ho Kyu; Kim, Young; Ha, Young Soo

Abstract

A clinical analysis was carried out with 400 cases of head injuries under 15 years of age admitted at the Department of Neurosurgery, Inha University Hospital during 4 years from 1987 to 1990. The material was classified into three groups according to main lesions, i.e. 1) simple cerebral contusion without skull fractures, 2) various types of skull fractures, 3) intracranial hemorrhagic lesions, representing such lesions as follows;a) epidural hematoma, b) subdural hematoma, c) intracerebral hematoma, intraventricular and subarachnoid hemorrhage. The results were as follows; 1) The age incidence was greatest in 7 years of age, and 188 cases(47%) were included in the age group between seven and ten. The accident occurred mostly from March to May, especially in April. 2) The head injuries were caused by traffic accident(203 cases:51%), fall down(152 cases:38%), etc. In clinical pictures, neck sprain(52.8%), nausea and vomiting(47.5%), and early epilepsy)9%) were developed. 3) The linear skull fracture was higher than other type fractures(74.6%) and the locations of skull fractures were parietal, occipital, temporal and frontal bone in order of frequency. 4) Among the intracranial hemorrhagic lesions, EDH was most common lesion, 73 cases(79%) of the patients with intracranial hemorrhagic lesions were accompanied by skull fractures but of the patients with skull fracture, 51.4% were accompanied by hemorrhagic lesions. Lucid interval was observed in 15 of the cases with intracranial hemorrhagic lesions and contre-coup injury was developed in 19(12%). 5) In the GOS, the high scored cases on the GCS were better than the low scored cases. 4 cases of 23 people scored under 8 on the GCS died. 14 cases of them were included in the age between 6 and 10(61%). 6) Associated injuries were found in about 16% of the total patient, the most common injury was clavicle fracture and most frequent sequala was post traumatic syndrome. The late epilepsy was occurred in about 13% of the early epilepsy cases except the cases had pre-traumatic epilepsy history.