Epidemiology of traumatic brain injury in children

Abstract

Severe traumatic brain injury (TBI) is a frequent cause of death and long-term disabilities. The epidemiology of severe TBI is not well-known due to variations in TBI definitions among the studies. Population based-studies are scarce, mostly including hospitalization data and rarely deaths on the scene. The annual incidence of severe TBI in the developed countries varies from 2.3 to 17 per 100,000 if based on Glasgow coma scale and reaches 46 per 100,000 if based on others classifications. Severe TBI represents 3 to 10% of all TBIs. The annual mortality rate of severe TBI varies from 2.5 to 9 per 100,000. The most frequent cause of severe TBI and TBI-related death in children is road accidents, falls being less frequent. Percentages of fall, child abuse, and direct hit by objects are higher in infants. Inflicted TBI, probably underestimated, belong to severe TBI and represent one quarter of severe TBI-related deaths in infants of less than one year. The case-fatality rate of severe TBI is around 15–20%. The rate of long-term disabilities varies according to the type of assessed disability and the tools used for its measurement. It is higher following an inflicted TBI. Among children with severe TBI, one third develops psycho-behavioral disorders, 20 to 30% disabilities and cognitive disorders and 60–70% fatigue, behavioral and concentration disorders. In more than 50% of TBI cases, familial dysfunctions occur.