Traumatic brain injury (TBI) is a major cause of death and disability in children. It is the leading cause of death in those over 1 year of age.
In 2004, the Centers for Disease Control (CDC) reported that TBI resulted in 216,000 emergency department visits, 18,000 hospitalizations, and 1,035 deaths in the 0-4 age group and 18,800 emergency department visits, 24,000 hospitalizations, and 1,250 deaths for those between the ages of 5 and 14 years of age (1).
The incidence of pediatric TBI peaks at two separate periods: below age 5 and in mid- to late adolescence. The incidence of hospitalization for TBI has been reported to be 125 per 100,000 children per year in the 15-17-year age group (2,3). Males are more likely to sustain TBI than females, at a ratio of approximately 60% to 40% (4).Children with a history of attention-deficit hyperactivity disorder (ADHD) are at a greater risk to sustain TBI than those without it. ADHD affects approximately 6% of children, has a male predominance, and a hereditary tendency. Of children who sustain TBI, prevalence of preinjury ADHD is noted to be between 10% and 20% (5).
Some authors have also evaluated the incidence of TBI in the United States by race. Langlois et al. (6) evaluated information from the National Center for Health Statistics. They reported a significantly higher rate of both hospitalization and death due to traffic/motor vehicle-related causes in children ages 0-9 in blacks compared to whites. Another group reported their experience in a regional trauma center and concurred that traffic/motor vehicle-related accidents were more frequently seen in minority children; however, there was no difference in death rates or the severity of brain injury (7).