Traumatic Brain Injury in Children: A Comprehensive Study of Epidemiology, Treatment, and Outcomes in Guntur, Andhra Pradesh

Abstract

Background: However, the precise occurrence of traumatic brain injury (TBI) in India is unknown, even though it is widely recognized as the leading cause of illness and death in infants and children. Furthermore, the types of injury, damage mechanisms, and management differ significantly compared to those in adults. Aim and objective: The purpose of this study was to investigate the occurrence, distribution, management, and outlook of traumatic brain injury (TBI) in children, as well as the different symptoms exhibited by children with TBI at a specialized hospital in Guntur, Andhra Pradesh. Materials and Methods: Between August 2022 and March 2023, our health facility conducted a cross-sectional study on all children under the age of 16 who presented to the neurosurgical emergency department with TBI. We reviewed the case records and collected data on clinical history, age, sex, injury mechanism, CT scan, management, morbidity, and mortality. The outcome of a traumatic brain injury (TBI) was defined by the findings of residual neurological abnormalities at the time of discharge. Results: Hospitalized were 54 cases of juvenile traumatic brain injury (TBI), with 36 males (67%) and 18 females (33%). The average age of the patients was 5.5 years. We classified the majority of cases as mild (65%), with a smaller proportion as intermediate (15%) and severe (20%). The primary cause of injuries was road traffic accidents, accounting for 43.8% of cases, followed by falls at 27.2% and slips at home at 26.4%. The symptoms seen were as follows: loss of consciousness (50%), vomiting (78%), and headaches (18.5%). The CT scans revealed a range of injuries, with 59.2% of cases exhibiting skull fractures. The treatments administered exhibited a range of proportions: 41% of cases necessitated mere monitoring, 31.4% necessitated medical intervention, 5.5% required surgical procedures, and 22.1% necessitated the use of mechanical ventilation. The mortality rate stood at 5.26%. Out of the individuals that survived, 50% did not have any lasting impairments. The remaining survivors reported symptoms such as headaches, weakness on one side of the body, partial weakness, seizures, and other medical issues. We found a strong correlation between residual impairments and the severity of the injury (p = 0.067), but found no significant correlation between the mechanism of damage and the outcome (p = 0.96). The mean duration of hospitalization was 5 days, with 65% of patients staying for less than 4 days. Conclusion: Parents and caretakers can prevent most of these injuries during infancy and childhood by ensuring proper vigilance and tender care. Parents must adhere to safe driving techniques when traveling with their children in their motor vehicles. We need to focus on grading the severity of TBI rather than on factors like age, mode of injury, and the presence or absence of external injuries.