Objective: Traumatic brain injury (TBI) by traffic accident in young children is not so often reported. Those patients were examined to clarify the status for further medical care.
Methods: Twenty five patients with TBI by traffic accident in recent 20 years whose age was under 6 years at injury were examined. We retrospectively investigated age at injury and present, causes, treatments during acute stage, outcome (physical disability, intellectual disability, higher brain dysfunction, epilepsy) and representative rehabilitation. We compared the degree of disability at infancy and at school age.
Results: The average age was 3 years 7 months at onset and 12 years 1 month at present. Accidents during walking were in 16 patients (64%), in the car were in 9 patients (36%). Glasgow coma scale under 8 in 18 patients (72%) was prominent. Types of brain damage were diffuse brain injury in 10 patients (40%), subduralhematoma in 8 patients (32%), contusion in 6 cases (24%), etc. Treatments at acute stage were coservative in 12 patients (48%), hematoma evacuation in 7 patients (14%), hypothermia in 6 patients (12%), etc. Outcome was physical disability in 10 patients (40%), intellectual disability in 20 patients (80%), higher brain dysfunction in 20 patients (80%), and epilepsy in 6 patients (24%). The degree of disability evaluated at school age was worse compared to that at infancy in 6 of 20 patients. The characteristics of those patients were as follows; no physical disability, no or mild intellectual disability, and higher brain dysfunction which became prominent after school age. Rehabilitation for memory disturbance and attention disturbance was presented.
Conclusion: The degree of disability should be evaluated after school attendance, especially with patients whose physical and intellectual disability was mild, and higher brain dysfunction was prominent.