Survivors of severe traumatic brain injury in childhood. I. Incidence, background and hospital course.

Survivors of severe craniocerebral injury in childhood require prolonged rehabilitation care. We have surveyed the incidence, social characteristics and early hospital course of such patients in Israel. Yearly incidence was 1:100,000. Thirty-six patients were surveyed. Thirteen of these patients (36%) were described as suffering from cognitive deficits prior to injury and in 11 families (30%), the parent pair showed disturbed function before the injury. Thirty-three of the patients (92%) were victims of road accidents, the child being a pedestrian in 70% of these. Duration of coma was over 1 week in all the children but one, and only a minority of the children underwent neurosurgical interventions. The data on premorbid disturbed function are highly suggestive but not conclusive in the absence of a relevant control group. However, the findings are in accord with findings in adult craniocerebral injured patients in whom recognizable social factors seem clearly associated with craniocerebral injury.