Clinical Features of Craniocerebral Injury in Children

ABSTRACT

The present study involves 667 patients of craniocerebral injury under 15 year old who were admitted to the Department of Neurosurgery, Yonsei Medical College and Wonju Christian Hospital from January, 1982 to December, 1983. The results of which were analyzed and evaluated as follows. 1) The proportion of male to female was 2 to 1, and one third of patients was from 2 to 7 years of age. 2) The most frequent cause of injury was traffic accident crash injury by truck and taxi and the next was fall from height and which were the causes of three quaters of all the craniocerebral injury of children. 3) Accidents were most frequent in May, and their frequent hour was from 3 P.M. to 4 P.M. 4) In 546 cases(81.9%), the consciousness was lost at the moment of the accident, and the duration was considered to be correlated with the clinical severity. Vomiting was observed in 353 cases(52.9%), and the early seizure attack accured in 31 cases(4.6%). 5) On admission, 631 patients were G.C.S. 8 and over, 25 patients were G.C.S. between 5 and 7,11 patients were G.C.S. 3 or 4. Two thirds of mortality cases were observed in G.C.S. under 7. 6) On plain skull films, skull fracture was observed in 292(43.8%) cases. Among those, depressed skull fracture was observed in 57 cases, and compound comminuted depressed fracture in 21 cases. By brain CT scan, abnormal hemorrhagic density was observed in 126 cases(18.9%), which involves 65 cases of epidural hematoma and 14 cases of subdural hematoma. In 47 cases, the hemorrhagic density was observed in intracerebral, intraventricular or intracerebellar region. 7) Associated injury accompanied by head injury was observed in 102(15.3%) cases, and mandible fracture, with or without tooth fracture, clavicle fracture, femur fracture, tibia fracture in order of frequency. It is considered that associated injury was one of the major causes of long term hospitalization and complication. 8) Total mortality rate was 3.1%, and the postoperative mortality was 6.9%.