Objetive: The intention of the study was to determine the clinical and epidemiological characteristics of the patients with TCE in minors of 18 years attended in 2 hospitals of reference of Lima.

Patients and Methods: There was realized a descriptive retrospective study of 2506 patients hospitalized in 2 centers of paediatric neurosurgery: The Health National Institute of  the Child and the Hospital of Paediatric Emergencies, during the year 1998 to 2002. The charts were checked and the information was grouped according to epidemiological variables as well as the characteristics of the patients with serious TCE.

Results: It was found a predominance of the masculine sex (61%), the age group more affected was that of 1-4 years (48 %) and the fall (45 %) was one of the most frequent reasons. The symptom mas common was the vomit (61.7 %) and the sign was the cefalohematoma (23.3 %). The CT scan was done in 69 % of the patients and in 44 % of these it was found some craneal or intracraneal injury, being the most frequent diagnoses fractures of vault (30.5 %), cerebral edema (14.9 %) and epidural haematoma (12.1 %). Epidural haematoma  of the convexity needed surgery in 61 % and that of posterior pit in 81 %. Acute subdural Haematoma  was rare (0.08 %). The mortality in the serious TCE was very high (13 %) being the accident of traffic the most common reason (42 %) and the cerebral contusion (58.3 %) the injury most associated with mortality.

Conclusions: The TCE in the paediatric patient has special characteristic clinical and epidemiological that separate it from the adult, characteristics that must be taken in bill for the implementation of a suitable plan of attention in emergency, improvement of the reference system and of  promotional preventive measurements with the purpose of decrese the morbimortalidad.

 

     Key words: Craneal trauma in children – Epidural haematoma – Skull fracture