[Traumatic head injury in children in south Tunisia epidemiology, clinical manifestations and evolution. a propos 454 cases]

ABSTRACT

To determine epidemiological, causes, clinical and Para clinical manifestations and outcome in children with traumatic head injury in south Tunisia. A retrospective study over a 8 year period [1997 - 2004] of 454 children's with head injury admitted to the Intensive Care Unit [ICU] of a university hospital [Sfax-Tunisia]. Basic demographic, clinical, biological and radiological data were recorded on admission and during the ICU stay. Mean age [SD] was of 7, 2 - 3, 8 years. The main cause of trauma was traffic accidents [69, 4%]. There were a predominance of male patient's with a sex-ratio of 2, 21. The Score of coma of Glasgow adapted to the child, was on average from8-3 points. Extra-cranial pathology was present were observed in 38, 9%. The cerebral CT-Scan performed on admission for all patients was pathological in 86, 3% of the cases. The most observed lesions were meningeal Haemorrhage [35, 2%] and the cerebral contusion [34, 5%]. According to the " Traumatic Coma Dated Bank classification " we noted a high proportion of type 2 group[46%]. Secondary systemic insults were observed in 377 children [83%]. Evolution was marked by the death of 82 children [18%]. Among survivors, a good recovery was observed in 229 children [50%]. In Tunisia, head injury is a frequent cause of hospitalization. It is essentially involved in traffic accidents. The short term prognosis is poor with a high [18%] mortality. Prevention is highly advised