Postraumatic intracranial hematomas in infancy - A 16-year experience

Objects: The objective of this study is to analyze some of the epidemiologi cal aspects in patients with post-traumatic intracranial hematomas (post-tr aumatic ICH) in infancy. These patients were treated at the Hospital Infant il Municipal de Cordoba, Argentina, between April 1980 and April 1996. Meth ods: A retrospective descriptive analysis was conducted on the 113 case his tories of children with post-traumatic ICH, all of whom required surgical i ntervention during this period. Relevant information such as age, sex, mech anism of injury causing craniocerebral trauma (CCT), and data on clinical p resentation on admission, diagnosis, morbidity and mortality rates were col lected. Conclusions: The series revealed a greater incidence of post-trauma tic ICH in boys (73.5%), whose average age was 6 years 5 months +/- 4 years 10 months (range 1 day to 15 years). Fifty-three percent of the girls suff ered post-traumatic ICH before the age of 3, while 54% of the children were 7 years of age or older (P < 0.05). Falls were the most frequent mechanism of injury causing CCT (36.3%), followed by vehicle accidents (33.6%) and u nknown causes (15.9%), the latter mainly in children under 3 years old (31% ). The most frequent symptoms were vomiting (58.6%), loss of consciousness (47.1%) and headaches (24.1%). Of all these children, 93.8% presented signs and symptoms at the time of hospital admission, alterations in the level o f consciousness (66%), vomiting (47.2%) and headaches (26.4%) being among t he most frequent. The hemorrhagic complications observed in the 113 patient s took the form of extradural hematomas (EDH) in 75 (66.4%), of subdural he matomas (SDH) in 35 (31.0%), of hemorrhagic contusions (Hc) in 19 (16.8%), and of intracerebral hematomas (Ich) in 11 (9.7%). In 13 patients the site of the hematoma was the posterior cranial fossa (11.5%), and 22.1% of patie nts presented more than one type of hemorrhagic complication. Morbidity rat es were 9.7% and mortality rates 17.7%.