RESUMEN
OBJECTIVE: To determine the number of children with minimal and mild traumatic brain injury (TBI) and their demographic factors, causes, associated signs/symptoms and management. METHODS: A cross-sectional analysis of consecutive presentations to a tertiary paediatric centre. RESULTS: There were 2043 presentations of minimal and mild TBI over 3 years (minimal TBI = 79.7% [n = 1628]; mild TBI = 20.3% [n = 415]). Mean age was 5.12 years (SD = 5.14) with children ≤3 years comprising 53.2% (n = 1086). There was a bimodal distribution in mild TBI with peaks at 0-2 and 13-15 years. The male-to-female ratio was 1.6:1. Only 34.6% of GCS scores were documented. Falls caused most injury. Overall, 6.3% (n = 129) required hospital admission and 29.1% (n = 594) were reviewed clinically. CONCLUSION: Minimal and mild TBI is common, representing a significant burden on individuals, families and healthcare providers. High rates of follow-up impact on the healthcare system and warrant further investigation.
Asunto(s)
Lesiones Encefálicas/terapia , Accidentes por Caídas/estadística & datos numéricos , Accidentes de Tránsito/estadística & datos numéricos , Adolescente , Distribución por Edad , Lesiones Encefálicas/epidemiología , Niño , Preescolar , Estudios de Cohortes , Estudios Transversales , Femenino , Escala de Coma de Glasgow , Humanos , Lactante , Puntaje de Gravedad del Traumatismo , MasculinoRESUMEN
OBJECTIVE: To describe the use of upper limb orthoses and assistive technologies (AT) in a representative community-based sample of children with hemiplegic cerebral palsy (HCP) and compare children on the basis of their prescription. METHOD: Survey of all children with HCP entered on a population register. Outcome measures included a clinical examination; Assessment of Motor and Process skills; Self-perception Profile for Children; PedsQL version 4; Paediatric Evaluation of Disability Inventory. RESULTS: Of 107 respondents, 56% were prescribed upper limb orthoses and 46% AT; 48% of children prescribed upper limb orthoses were using them, compared to 98% of children prescribed AT. Greater tone at the wrist was associated with orthotic prescription (OR [95% CI] 39.6 [4.8, 323]). CONCLUSION: Children with HCP prescribed orthoses and AT are a more severely affected group. AT have higher utility than upper limb orthoses in children with HCP, with orthoses having a high rate of abandonment.