Evaluation of the neurosurgical events with detailed demographic factors in pediatric traumas

Abstract

In this study, we aimed to investigate the incidence of neurosurgical events in patients with childhood trauma to determine risk factors and to standardize the neurosurgical approach to pediatric trauma for reducing the request of unnecessary tomography imaging. According to the age distribution of children aged 17 and under who applied to the emergency department from Jan 2019 to Jan 2021 was examined in 3 separate groups; the infant-early childhood group (0-3 years old), the preschool group (4-7 years), and the pre-adolescence and adolescence group (8-17). Radiological images, type of trauma, neurosurgical damage of trauma (spinal, cranial) and treatment approaches were examined. The mean age of 1247 pediatric trauma patients admitted to the emergency department within two years was 7.71 ± 5.01. The most common reasons in terms of trauma etiology were found to be falling from height (61.2%), traffic accidents (26.5%), and then running into a hard object (10%). It was determined that 249 (19.3%) of the patients were consulted to the Neurosurgery department and 128 patients were hospitalized to the neurosurgery service due to spinal (n: 29) and cranial (n: 99) events. 11 of these patients were operated due to cranial, 2 to spinal events and a patient with spinal injury was followed up with conservative treatment due to SCIWORA (spinal cord injury without radiographic abnormalities). Although trauma is the most important cause of mortality and morbidity in the pediatric age group, most of them are preventable. Computed tomography (CT) indications for pediatric head/spinal traumas are still controversial. We think that unnecessary CT usage should be avoided as much as possible, although there is a need for imaging in order not to miss the diagnosis of severe traumatic brain injury.