67 woman this month | January 2012 | H ead injuries affecting children are common reasons for medical consultation and evaluation, both in the emergency room and in the paediatric clinics; they are also the most common causes of disability and death in children. Studies show an estimate of more than 10,000 children become disabled from a brain or head injury each year. More than half of the presentations to the emergency rooms of this sort are accounted for by young girls and boys of under five years — more so among the boys. “It is known that trauma is the leading cause of death among infants and children; where the common etiologies can range from automobile accidents, bicycle injuries, falls from heights of four feet and above to non-accidental trauma like child abuse. In some parts of the world, even injuries from skating and missile shots are also listed as common causes!” says paediatrician Dr. Jofrelyn Bistoyong. Dr. Jofrelyn continues to explain that other than the obvious cases, where open and penetrating wounds on the head are visible, signs to watch out for include symptoms like headache, three or less episodes of vomiting, brief fainting or loss of consciousness. “For those with moderate head injuries, they become progressively lethargic, with loss of consciousness for more than five minutes, increasing severity of headache, more than three times vomiting, sometimes with posttraumatic amnesia,” she continues. These cases also tend to present with signs of multiple trauma, serious facial injury, leaking fluid from the brain in ears and nose. Infants and children with a severe head injury, however, present with severe lethargy or drowsiness, evidence of penetrating skull injury, depressed skull fractures and neurological deficits. These and more childhood injuries are very thoroughly managed at the BSH, where children who are alert and awake may be observed for about four hours in the ER and if there is no deterioration in status, do not need a radiographic examination nor hospitalisation. “A brain CT scan is the most common examination administered in head trauma cases. In the event of deterioration of level of consciousness; prolonged confusion; excessive vomiting; questionable mechanism of injury or unwitnessed trauma; presence of neurological signs, seizures or skull fracture, an admission to the hospital is warranted. Our multispecialty team of doctors, composed of the paediatrician, radiologist, neurologist and neurosurgeon, is usually involved in the overall treatment of head injuries in kids.” Most children with head injuries make a full recovery, BSH hand over a special leaflet to parents highlighting specifically what to look for after they get home what warrants a return to the ER or phoning the doctor. Call 17 812-000. Children are prone to bumping their heads every now and then. Bahrain Specialist Hospital (BSH) tells us when we should and shouldn’t panic! Head Injury Dilemmas BAHRAIN SPECIALIST HOSPITAL
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