• Clemens Weber, Joakim Stray Andreassen, Maziar Behbahani, Kenneth Thorsen, and Kjetil Søreide.
• Department of Neurosurgery, Stavanger University Hospital, Postboks 8100, 4068, Stavanger, Norway. clemens.weber@uis.no.
• Eur J Trauma Emerg Surg. 2022 Dec 1; 48 (6): 447344804473-4480.

PurposeThe aim of this study was to explore patient and injury characteristics, image findings, short-term clinical outcome and time trends of moderate and severe traumatic brain injury in severely injured children.MethodsThis study is an observational cohort study based on prospectively collected data from an institutional trauma registry database covering all trauma patients in South West Norway. All paediatric patients registered in the database between 01.01.2004 and 31.12.2019 were included.ResultsDuring the 16 years-study periods, 82 paediatric patients with moderate (n = 42) and severe (n = 40) traumatic brain injury were identified. Median age was 13.0 years, 45% were female and median Glasgow Coma Scale score at admission was 9.0. Cranial fractures were common image findings in both groups. Cerebral contusions (32%) and epidural hematomas (29%) were more commonly found in moderate traumatic brain injury; cerebral contusions (49%), diffuse axonal injury (31%) and cerebral oedema (46%) were more prominent in severe traumatic brain injury. All children with moderate traumatic brain injury survived and favourable outcome was registered in 98%. Overall mortality in the severe traumatic brain injury cohort was 38% (thereof 25% due to TBI) and only 38% had a favourable short-term outcome.ConclusionsIn this population-based study on paediatric trauma patients over a period of 16 years severe traumatic brain injury in children still had a considerably high mortality and a higher proportion of patients experienced an unfavourable clinical short-term outcome. Moderate traumatic brain injury resulted in favourable clinical outcome.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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