Emejulu J K C, Shokunbi M T
Neurosurgery Unit, Department of Surgery, Nnamdi Azikiwe University TeachingHospital, Nnewi, Anambra State, Nigeria.
Niger J Clin Pract. 2010 Sep;13(3):276-9.
Trauma is the most common cause ofpaediatric deaths. In 75% ofpaediatric trauma deaths, head injury is responsible, and most are from falls. Recent reports from Nigeria, however, appear to indicate a predominance of road traffic accidents, instead of falls.
To evaluate the aetiology of paediatric head trauma, management protocols and outcome from our Centre, in order to acquire a baseline data base and recommend measures to reduce childhood trauma.
A prospective study of all paediatric head trauma cases presenting to Nnamdi Azikiwe University Teaching Hospital, Nnewi, for 12months from April 21, 2006 to April 20, 2007, was done and collated data subsequently analyzed. The paediatric age group was taken as = 15 years, and grading of head injury was with the Glasgow Coma Scale (3-15) and the modified scale for non-verbal children; while outcome was measured with the Glasgow Outcome Scale (1-5).
Out of 334 patients treated within the period of study, 210 were head trauma cases. Of these, 52 were paediatric head trauma, representing 24.8% of all head trauma cases; and 19.2% (10 of 52) of them were aged 0-2 years. About 62% (32 of 52) were males. Falls and RTA were each responsible in 25 (48.1%) cases. Mild head injury occurred in 31 (59.6%), and 49 (94.2%) patients were evaluated by plain radiography. Treatment was conservative in 39 (75%) cases; with satisfactory outcome in 36 (69.2%), and a mortality rate of 15.4%.
Road traffic injury, mostly from motorcycles, has become the major cause of morbidity and mortality amongst the paediatric age group, especially the male gender, and outcome from management is mostly satisfactory.
创伤是儿童死亡的最常见原因。在75%的儿童创伤死亡病例中，头部损伤是致死原因，且大多数是因跌倒所致。然而，来自尼日利亚的近期报告似乎表明，道路交通事故而非跌倒占主导地位。
评估我院儿童头部创伤的病因、管理方案及治疗结果，以获取基线数据库并推荐减少儿童创伤的措施。
对2006年4月21日至2007年4月20日期间在Nnewi的Nnamdi Azikiwe大学教学医院就诊的所有儿童头部创伤病例进行了为期12个月的前瞻性研究，并对整理后的数据进行了分析。儿童年龄组设定为≤15岁，头部损伤采用格拉斯哥昏迷量表（3 - 15分）及针对非言语儿童的改良量表进行分级；而治疗结果则用格拉斯哥预后量表（1 - 5分）进行评估。
在研究期间接受治疗的334例患者中，有210例为头部创伤病例。其中，52例为儿童头部创伤，占所有头部创伤病例中的24.8%；其中19.2%（52例中的10例）年龄在0 - 2岁。约62%（52例中的32例）为男性。跌倒和道路交通事故各占25例（48.1%）。轻度头部损伤发生在31例（59.6%），49例（94.2%）患者接受了X线平片检查。39例（75%）病例采用保守治疗；36例（69.2%）治疗结果满意，死亡率为15.4%。
道路交通伤害，主要来自摩托车，已成为儿童年龄组尤其是男性发病和死亡的主要原因，且治疗结果大多令人满意。
