Clinical Profile of Paediatric Head Injury Patients at a Tertiary Care Teaching Hospital of Gujarat, Western India: Prospective Observational Study

Introduction: Paediatric Traumatic Brain Injury (TBI) is a leading cause of morbidity and mortality in children. The accompanying Cervical Spine Injuries (CSI) are not well studied in the Indian subcontinent, particularly with respect to adherence to stabilisation protocols during inter-hospital referrals. Aim: To evaluate the clinical profile, neuroimaging characteristics, and outcomes of paediatric TBI cases at a tertiary care hospital in Gujarat, Western India. Materials and Methods: The present one-year, prospective, observational study included 95 paediatric patients (1 month to 18 years) with head injuries who presented to a tertiary care teaching hospital in Gujarat, Western India, between October 2023 and September 2024. Data were collected on demographics, mechanisms of injury, symptoms, neuroimaging, transport, cervical spine immobilisation, hospital course, and outcomes. Descriptive and inferential analyses were used to describe the profile and examine associations between key parameters. Results: Among 95 patients, 74 (77.9%) were males. Nearly half (47, 49.5%) were below eight years of age. Falls (39, 41.1%) and Road Traffic Accidents (RTA) (38, 40%) were the most common causes of injury. Only 2 (2.1%) children received cervical spine immobilisation during transport. Of the total, 31 (32.6%) were moderate-to-severe cases, and neuroimaging was indicated or performed in 30 (31.9%). Out of these 30, Subdural haematoma (13, 43.3%) and cerebral contusions (10, 33.3%) were the most frequent radiological findings. Most patients (60, 63.2%) were discharged within 48 hours. Full recovery occurred in 77 (81.1%), while 17 (17.9) had disabilities and 1 (1.1%) died. Lack of cervical spine stabilisation and the need for intubation were significantly associated with poorer outcomes (p<0.05). Conclusion: Most patients were male, and mild-to-moderate head injuries were common. A substantial number of severe cases were also noted, with subdural hematoma and contusions strongly linked to poor neurological outcomes. Only two patients received cervical spine stabilisation during transport, highlighting a major gap in prehospital trauma care.