Objectives

To study the incidence of diffuse axonal injury among head trauma pediatric patients, mode of injury, role of neuro-imaging, significance of non-invasive ICP monitoring, rate of surgery done, role of rehabilitation and outcome in terms of 30-day survival rate, effect on cognition, with a follow-up period of 6 months.

Materials and methods

A prospective non-randomized clinical study was done in the patients under 16 years of age with diffuse axonal injuries following head trauma from January, 2016 to November, 2017 at Lilavati hospital and research centre with follow up period of 6 months. GCS, neuro-imaging and behavioral assessment was done on admission, day 3, day 5, day 7, day 30 and 6 months.

Results

Total patients studied during the period were 16 patients; 10 were males and 6 were females and age varied from 1 month to 16 years. One patient developed diffuse axonal injury due to abuse at home by father. 13 out of 16 cases improved in sensorium in average 6.8 days. 14 out of 16 cases showed significant improvement with no/minimal neurological deficit at 6-month follow-up.

Conclusions

Most of the patients need conservative management with intense neuro-observation. Intra-cranial pressure monitoring is very important in pediatric patients. Multiple modalities including physiotherapy, psychotherapy and behavioral therapy improve the outcome significantly.