Prevalence of traumatic brain injury amongst children admitted to hospital in one health district: a population-based study.

There is a dearth of information regarding the prevalence of brain injury, serious enough to require hospital admission, amongst children in UK. In North Staffordshire, a register of all children admitted with traumatic brain injury (TBI) has been maintained since 1992 presenting an opportunity to investigate the incidence of TBI within the region in terms of age, cause of injury, injury severity and social deprivation. The register contains details of 1553 children with TBI, two-thirds of whom are male. This population-based study shows that TBI is most prevalent amongst children from families living in more deprived areas, however, social deprivation was not related to the cause of injury. Each year, 280 per 100,000 children are admitted for >or=24h with a TBI, of these 232 will have a mild brain injury, 25 moderate, 17 severe, and 2 will die. The incidence of moderate and severe injuries is higher than previous estimates. Children under 2 years of age account for 18.5% of all TBIs, usually due to falls, being dropped or non-accidental injuries (NAIs). Falls account for 60% of TBIs in the under 5 years. In the 10-15 age group road traffic accidents (RTAs) were the most common cause (185, 36.7%). These findings will help to plan health services and target accident prevention initiatives more accurately.

Parental stress and burden following traumatic brain injury amongst children and adolescents.

PRIMARY OBJECTIVES: To assess parental stress following paediatric traumatic brain injury (TBI), and examine the relationship between self-reported problems, parental stress and general health. RESEARCH DESIGN: Parents of 97 children admitted with a TBI (49 mild, 19 moderate, 29 severe) to North Staffordshire National Health Service Trust, and parents of 31 uninjured children were interviewed and assessed. METHODS AND PROCEDURES: Structured interviews were carried out with families, and parents assessed on the Parenting Stress Index (PSI/SF) and General Health Questionnaire (GHQ-12) at recruitment, and repeated 12 months later. MAIN OUTCOMES AND RESULTS: Forty parents (41.2%) of children with TBI exhibited clinically significant stress. Regardless of injury severity, parents of injured children suffered greater stress than control parents as measured by the PSI/SF (p = 0.001). There was a highly significant relationship between number of problems reported and level of parental stress (p = 0.001). Financial burden was related to severity of TBI. At follow-up, one third of parents of children with severe TBI scored > or =18 on the GHQ-12, signifying poor psychological health. CONCLUSIONS: The parents of a child with serious TBI should be screened for abnormal levels of stress. Parental stress and family burden may be alleviated by improved information, follow-up and support.

Children's brain injury: a postal follow-up of 525 children from one health region in the UK.

PRIMARY OBJECTIVES: To follow-up a population of children admitted to one Hospital Trust with traumatic brain injury (TBI), and compare outcomes following mild TBI with outcomes following moderate or severe TBI. RESEARCH DESIGN: Population-based postal questionnaire survey. METHODS AND PROCEDURES: Questionnaires were mailed to parents of all 974 surviving children on a register of paediatric TBI admissions, 525 completed questionnaires were returned (56.2%). Most children (419) had suffered mild TBI, 57 moderate, and 49 severe. MAIN OUTCOMES AND RESULTS: Thirty per cent of parents received no information on post-injury symptoms, and clinical follow-up was limited. Statistically significant differences were observed between mild and moderate/severe groups for cognitive, social, emotional, and mobility problems. Nevertheless, approximately 20% of the mild group suffered from poor concentration, personality change and educational problems post-injury. Few schools (20%) made special provision for children returning after injury. CONCLUSIONS: Children can have long-lasting and wide-ranging sequelae following TBI. Information should be routinely given to parents and schools after brain injury.