RESUMO
AIM: To determine epidemiological, causes, clinical and Para clinical manifestations and outcome in children with traumatic head injury in south Tunisia. METHODS: 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. RESULTS: 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 from 8 +/- 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 (50.4%). CONCLUSION: 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.
