Compound head injury in 46 pediatric patients

The purpose of the present retrospective study was to analyze the pediatrics patients with compound head injury (CHI), and evaluate the incidence of complication in our setup, and to assess the various factors responsible for the ultimate outcome. During the 17-year-period (1990 to 2007), 46 pediatric patients under the age of 20 years with CHI were managed in two departments. The detailed clinical profile and radiological finding of these children were noted. Male to female ratio was 4.7:1. Mean age was 12.3 years. Major mode of trauma was road traffic accident; other causes included assault, fall from the height and missile injuries etc. Out of total 46 patients, 29 patients (64%) were treated surgically and 17 (36%) were managed conservatively. Complications were observed in 13 patients (29%). Meningitis was the most common, diagnosed in 6 cases (12%). Good recovery was observed in 20 cases (43%). Six children (13%) were moderately disabled, twelve (26%) were severely disabled and eight (17%) died. CHI has the risk of complications i.e. meningitis, seizure, CSF leak etc. Dural tear, free bone fragments and late presentation (more than 8 hours after trauma) were the important risk factors. Early surgery and adequate debridement with antibiotic cover play an important role in reducing the complication rate in children with compound head injury.