Article
Epidemiology of head injuries and initial diagnostic methods in newborns and infants in Germany
Epidemiologie der Kopfverletzungen und diagnostischen Methoden in Neugeborenen und Säuglingen
Search Medline for
Authors
Published: | May 8, 2019 |
---|
Outline
Text
Objective: Head injuries are playing a crucial role as contributors to higher morbidity, mortality and disability among children and young adults. The epidemiologic data on this topic are rare. We have evaluated epidemiologic data of new-borns and infants after head injury.
Methods: We have analysed data of children up to 1 year of age treated for head injury (ICD 10; S06.0-9) in the period of 2005 to 2015. Treating departments included traumatology, pediatrics, pediatric-surgery and neurosurgery. Demographic data, trauma mechanism, concomitant injuries, neurological status at admission and at discharge, surgical procedures, number of ultrasound investigations (US), CT and MRI scans and intracranial injuries were analyzed. The severity of trauma was based on the adapted Glasgow-Coma-Score (mild:moderate:severe).
Results: Total number of 1163 infants with head injury were evaluated. Most of infants were males (N=615, 52.9%). The most of the young patients sustained mild TBI (99.4%).Concomitant injuries were seen in 672 cases (57.8%) of cases. The leading mechanism of injury was a fall (N=1057, 90.9%) which occurred mostly at home (N=936, 80.5%). Cranial fracture was noted in 10.7% of cases (N=125). In 11 (1.0%) cases a neurosurgical procedure was necessary. Surgical treatment was mostly performed due to an intracranial hematoma (N=8, 0.7%). US was performed in 65.5% of cases (N=762). One CT scan was done in 30 patients (2.6%). In 5 infants (0.4%) more than one CT was necessary. MRI was performed in 19 cases (1.6%). 4 (3.4%) children needed more than 1 MRI scan. Most of the infants achieved very good clinical outcome (mRS 0 – 97.4%, GOS 5 97.8%)
Conclusion: The main cause of head injuries in infants are falls that result mostly in mild TBI injuries. Typically, falls occur mostly at home. CT scans and consequently neurosurgical intervention are rarely needed in infants. US is one of the most important bedside tool in the acute diagnostic of this patients’ group. Preventive measures and its awareness are necessary to decrease the incidence of head injuries in infants.