title: Spectrum and outcome of traumatic brain injury in children <15 years: A tertiary level experience in India.
abstract: BACKGROUND
  Though, traumatic brain injury (TBI) has been documented as the single most common cause of morbidity and mortality in infancy and childhood, the exact incidence is unavailable in India. Moreover, modes of injury, mechanisms of damage, and management differ significantly from that of an adult.
  
  
  OBJECTIVE
  To analyze the epidemiological factors, the spectrum of TBI, modes of injury, types of injury, and the outcome in the children <15 years with TBI.
  
  
  METHODS
  This is a retrospective study from August 2012 to May 2013 at Department of Neurosurgery, S.C.B. Medical College, Cuttack, Odisha, India. All the pertinent details from case records of hundred and forty-seven children <15 years with TBI were analyzed. Follow-up was done for 6 months at outpatients department.
  
  
  RESULTS
  Age wise, incidence and severity of TBI is more common in 10-15 years. Males outnumber females with a male: female ratio 2.19:1. Overall, road traffic accident (RTA) is the commonest mode of injury. Assault is not uncommon (7.48% cases). Falls is common in <5 years while RTA is common in 5-15 years. The extradural hematoma was the most common injury pattern; however, surgical consideration was maximal for fracture skull. Overall mortality was 7.48%. Diffuse axonal injury has the maximum individual potential for mortality. We noticed excellent recovery in 68.7%, disabilities in 17.68%, and persistent vegetative state in 5.45% cases.
  
  
  CONCLUSIONS
  TBI in children carries good outcome, if resuscitated and referred early to a neurotrauma center, and managed subsequently on an individualized basis with a well-organized team approach. Severe TBI in children has a poor outcome.
authors.affiliation: Department of Neurosurgery, S.C.B. Medical College, Cuttack, Odisha, India.
authors.forename: Mani Charan
authors.initials: MC
authors.lastname: Satapathy
authors.affiliation: Department of Transfusion Medicine, S.C.B. Medical College, Cuttack, Odisha, India.
authors.forename: Dharitri
authors.initials: D
authors.lastname: Dash
authors.affiliation: Department of Neurosurgery, S.C.B. Medical College, Cuttack, Odisha, India.
authors.forename: Sudhansu Sekhar
authors.initials: SS
authors.lastname: Mishra
authors.affiliation: Department of Neurosurgery, S.C.B. Medical College, Cuttack, Odisha, India.
authors.forename: Soubhagya Ranjan
authors.initials: SR
authors.lastname: Tripathy
authors.affiliation: Department of Neurosurgery, S.C.B. Medical College, Cuttack, Odisha, India.
authors.forename: Pratap Chandra
authors.initials: PC
authors.lastname: Nath
authors.affiliation: Department of Neurosurgery, S.C.B. Medical College, Cuttack, Odisha, India.
authors.forename: Somnath Prasad
authors.initials: SP
authors.lastname: Jena
keywords: Craniotomy; Glasgow coma scale; Glasgow outcome scale; extradural hematoma; head injury; loss of consciousness; pediatric age group; road traffic accident; traumatic brain injury