Trauma to the nervous system and its sequelae in a one-year birth cohort followed up to the age of 14 years

Abstract

The one-year birth cohort of 12 058 children, 96% of all children born in the two northernmost provinces of Finland, Oulu and Lapland, in 1966 was studied prospectively up to the age of 14 years. During this period 14 children, 1.2 per thousand, were lost from the follow-up. Data on development, mortality, and morbidity were collected prospectively by means of questionnaires and from various registers, the most important of which was the National Hospital Discharge Register. A total of 299 cases of trauma to the nervous system (skull fracture, cerebral contusion, concussion, fracture of the vertebral column with spinal lesion, injury to the cranial or peripheral nerves) occurred in 286 children, 116 girls and 170 boys, which yields a cumulative incidence of nervous system trauma of 24.1 per thousand. The trauma was fatal in 11 boys and 7 girls, 63 per thousand of all children with neurotrauma, and 136 per thousand of all cases of death occurring in the age group 29 days to 14 years. Spinal injury occurred in 12 children, cerebral contusion in 28, skull fracture in 19, and concussion in 216. Such trauma resulted in chronic disease, cerebral palsy, mental retardation, and epilepsy in 16 children, 5.6% of all children with neurotrauma and 3.2% of the 495 children in the cohort with cerebral palsy, epilepsy or mental retardation only.