title: Paediatric head injuries in the Kwazulu-Natal Province of South Africa: a developing country perspective.
abstract: We investigated the causes, management and outcome of head injuries in paediatric patients admitted to the paediatric surgery unit at King Edward VIII Hospital over a 3-year period, from 1999 to 2001. There were 506 patients (331 male; M:F ratio 2:1) and the mean age was 71.99 +36.8 months (2 weeks to 180 months). The injuries were due to: motor vehicle crashes (324); falls (121); assault (30); inadvertent injury (23); and unknown (11). Forty-nine patients (9%) were admitted with a Glasgow Coma Scale ≤8. The most common intracranial pathology on computed tomography was: intracranial haematoma/haemorrhage (44); contusion (16); and brain oedema (10). Nineteen patients (3.4%) underwent neurosurgical intervention and the rest were managed conservatively. Eighteen died in hospital (3.6%). The mean hospital stay was 5 ± 12 days. Twenty-three patients (4.5%) were discharged with neurological sequelae. Few paediatric patients are admitted with severe head injury: the majority from blunt injury caused by motor vehicle crashes. Management mainly requires simple neurological observation in a general ward with a surprisingly good prognosis. Specific protocols for paediatric head injuries have been proposed based on these findings.
authors.affiliation: Department of Surgery, University of KwaZulu-Natal, Congella, Durban 4013, South Africa.
authors.forename: Ebenezer K
authors.initials: EK
authors.lastname: Okyere-Dede
authors.forename: Munyaradzi C
authors.initials: MC
authors.lastname: Nkalakata
authors.forename: Tshepo
authors.initials: T
authors.lastname: Nkomo
authors.forename: G P
authors.initials: GP
authors.lastname: Hadley
authors.forename: Thandinkosi E
authors.initials: TE
authors.lastname: Madiba
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D003906:Developing Countries; D005260:Female; D015600:Glasgow Coma Scale; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology