Profile of Pediatric Traumatic Brain Injury in South-West Nigeria

Abstract

Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children. In Nigeria, there is paucity of information about TBI in children. We describe the profile of pediatric TBI in a university hospital in South-West Nigeria. A retrospective study of children who had TBI from 2012 to 2022 was performed. Data were extracted from the neurosurgery database. Patient demographics, etiology/patterns of injuries, clinical/radiologic findings, management, and outcomes were assessed. We performed simple descriptive analyses. Pediatric TBIs represented 20% (128) of the head injury admissions (631). There was male preponderance (male/female= 1.8:1); most patients were adolescents (29%). In total, 61%, 18%, and 21% had mild, moderate, and severe TBI, respectively. Road traffic crashes were responsible for 74% of cases, with motorcycle accidents (46%) much greater than motor vehicular accidents (28%), mostly pedestrian (51%). Fall from heights accounted for 21%, mostly in toddlers. A total of 70% had associated injuries, mainly skull fractures (54%) and soft-tissue injuries (47%). In total, 31% had post-traumatic seizures. Only 40 (31%) had a cranial computed tomography scan. Common findings were contusions in 70%, extradural hematomas in 28%, and intracranial aerocoeles in 18%. There were no neurosurgical lesions in 20%. Six had operative intervention. Mortality rate was 12%. In total, 84% had good recovery. The average follow-up period was 7 months. Children account for a large number of TBIs in our environment, which are mostly from road traffic crashes and falls. Only a few received computed tomography scan of the brain. Most cases had nonoperative care, and outcomes are worse with increasing severity of head injury. Specific preventive measures need to be formulated and/or enforced by governments at all levels.