113: Incidence and Mechanisms of Mild Traumatic Brain Injury in Children Presenting to the Emergency Room

Abstract

Mild traumatic brain injury (mTBI), often called concussion, is a common injury sustained by children participating in sports and recreational activities. There is evidence to suggest that children who has sustained a concussion is at increased risk for subsequent head injuries, and that such injuries may be cumulative and lead to prolonged or persistent symptoms. Prevention strategies for mTBI should aim at age-specific mechanism of injury. The aim of this study was to determine the mechanisms of minor traumatic brain injury (mTBI) among children presenting to the emergency room. A retrospective study of all emergency room visits for minor traumatic brain injury suffered by children between zero and 18 years of age between November 2010 and November 2011. Children with loss of consciousness, post-traumatic amnesia and/or short-lived impairment of neurological function were considered to suffer from mTBI. A total of 518 cases of mTBI were reported, 87 were not considered for this study due to missing information required for diagnosis of mTBI. A total of 431 confirmed case of mTBI were identified with an estimated incidence of 12.7 per 1000 children per year (95% CI 11.6 to 13.9 per 1000). Of these, 191 (44%) were children between 0 and 4 years of age, 70 (16%) five to nine years old, 96 (22%) 10 to 14 years old and 74 (17%) 15 to 17 years old. The two most frequent mechanisms leading to mTBI were falls from height (38%) and sports related injury (27%). The latter was responsible for 61% of mTBI suffered by children between 10 and 17 years of age, when, on the other hand, falls from height represented 69% of the zero to four years old cases. mTBI is very prevalent in the pediatric population and is caused by a variety of mechanisms. This study reveals that mTBIs affect preschoolers at home resulting from a fall from a height in proportion comparable to sports related mTBI among older children.