Pediatric head injuries caused by traffic accidents. A prospective study with 5-year follow-up.

In an unselected series of 488 patients with head injuries referred to a general surgical department, there were 126 children aged 0-19 years whose head injuries were a result of traffic accidents. In age group 0-4 years, only 23% of the head injuries were due to traffic accidents. In age groups 5-9, 10-14, and 15-19 years, however, traffic accidents were the main cause of the injuries, being responsible for 47%, 65% and 82% of the cases respectively. Both age groups 5-9 and 10-14 years had an unusually high proportion of bicycle injuries, while motorcycle and automobile accidents were the leading causes of injury in age group 15-19 years. Eight children (6%) died as a result of head trauma. Furthermore, among the survivors there were 8 children with severe head injuries (post-traumatic amnesia lasting 24 h), the rest being minor head injuries. All the survivors but one returned to school and achieved reasonable performances. Repeated follow-up studies at 3 months, 1 and 5 years, including interviews with the parents, disclosed that several of the children had headache, dizziness and other complaints. These subjective complaints subsided with time, but with different patterns, in the younger and older age groups. It is concluded that the "postconcussional syndrome" is not uncommon in children, but it may be better tolerated and resolves more completely with time than in adults. Eight children (7%) had one seizure or more during the 5-year follow-up period.