Head injuries in children and adolescents: causes and natures

To investigate the nature of exposure factors, and effectiveness of countermeasures in head injuries in children and adolescent of Taiwan area, we conducted a retrospective study on 820 children and adolescents with head injuries consecutively admitted to Chang Gung Memorial Hospital from January 1985 to December 1989. We analyzed the data by chart review and divided the cases into four age-groups: group A (0-4 years old), group B (5-9 years old), group C (10-14 year old) and group D (15-17 years old). The boy to girl ratio was 2.43. The largest proportions of head injuries were the adolescents in group D. The most common cause of head injury was traffic accidents (74%); while the falls were contributed the main cause in other studies. In all group A, B and D, the majority of traffic accidents were pedestrian injury; while in group D, the motorcyclists or car drivers were responsible for the accidents. Fall from height was the major cause of fall in all four age-groups, but it was fall from bicycle or during play or sports in group C. Injuries were most common in summer and clustered at afternoon in all patients. Majority of head injuries occurred outdoors. Most children and adolescents suffered from mild head injury, but there were still 203 cases with severe head injury (24%). Eighty-one cases (9.9%) were either discharged in critical condition or died at the hospital. There were no significant differences in mortality among four age-groups.