ABSTRACT
Objective: Head traumas are prevalent in children with mild severity and without commitment of delayed brain injuries. The aim of present study was to detect the mild head trauma (MHT) children with high risk of brain injuries for avoidance of unnecessary interventions. Methods: This cross-sectional study considered 100 children under 2 years old with MHT in Kashani and Alzahra Hospitals between March 2011 and August 2011, Isfahan, Iran. Data was gathered by these project executives including the radiologist reports and the patients past medical history. The patients were divided into normal and abnormal CT scan and reduction of consciousness level, vomiting and the other variables were considered. Results: The results were obtained from evaluation of 100 files from the patients with mean age 18±7.1 month. CT scan findings showed that 55 percent of the patients were abnormal and had burn injuries including skull fracture, epidural hemorrhage, skull contusion, and arachnoids hemorrhage. The incidence of repeated vomiting and reduction of consciousness level in patients with non-normal CT scan was more than normal group while this difference was not significantly different. Also according to CT scan findings there was no statistically significant difference between patients with repeated vomiting or reduced consciousness level (P>0.05). Conclusions: This study results showed that there is not significantly difference between vomiting incidence, deceased level of consciousness and CT scan results. These criteria were not considered separately as only factors for burn trauma of performing CT scan in MHT patients.
ABSTRACT
OBJECTIVE: The elderly population is rapidly growing, and the population over age 65 is expected to increase. To evaluate factors that determine recovery in this population, we report a clinical analysis of 77 elder patients of mild head trauma over 65 years of age. METHODS: The medical records were reviewed retrospectively for 77 head-injured patients aged 65 to 85 years who were admitted to our institution between March, 1995 and December, 1999. The outcome was compared with age, sex, Glasgow Coma Scale score, and radiologic characteristics. RESULTS: As in all age groups, males predominated and motor vehicle accidents accounted for a highest proportion(35%). Of the traffic accidents, pedestrian injuries were more common. The single most common lesion was subdural hematoma. The initial radiologic findings were not correlated with outcome. The GCS score was statistically correlated with prognosis. Sixty-one patients(79.2%) had favorable outcome. Ten of seventy-seven patients(13%) died whereas cerebral injury accounted for 5 deaths. Non-cerebral causes of death were composed of pneumonia, multi-organ failure and sepsis. The mean hospitalization was 52.3+/-12.6 days. CONCLUSION: The mortality rate after injury is higher in elderly patients. It is therefore the factors of intracranial and extracranial cause which influence survival and outcome be carefully treated. Neurologic deficits, even though mild, are the risk factor of poor prognosis in the elderly. Earlier identification of risk and aggressive support may be needed for decreasing the morbidity and the mortality in the elderly.