HEAD-INJURY AS A RISK FACTOR FOR BRAIN-TUMORS IN CHILDREN - RESULTS FROM A MULTICENTER CASE-CONTROL STUDY

We evaluated the risk of brain tumor occurrence in relation to previou s head injury in a population-based case control study of 540 children with a primary brain tumor and 801 control children. The risk of a br ain tumor among children with a previous head injury that resulted in medical attention was slightly elevated when compared with children wi th no re ported head injury [odds ratio (OR)=1.4; 95% confidence limit s (CL)=1.0, 1.9]. This effect was stronger when;we restricted the head -injured group to the few children with loss of consciousness (OR=1.6; 95% CL=0.6, 3.9) or an overnight admission to a hospital (OR=1.7; 95% CL 0.7, 4.6), relative to those with no head injury. We observed no a ppreciable association between brain tumor occurrence and birth injury involving the head or a forceps delivery. Among the few children with either a birth injury or forceps delivery and a subsequent head injur y, we observed approximately twofold elevations in risk. The OR was 2. 6 (95% CL=1.1, 6.9) for those with a birth injury and subsequent head injury, relative to those with neither a birth injury nor head injury. Our results provide only weak evidence in support of head injury as a n etiologic agent for brain tumor occurrence in children, although mos t of our exposed group had only mild head injury.