Head injuries in children: a chronicle of a quarter of a century

Children aged 0–15 years hospitalized in Geneva for head trauma during the last quarter of a century are reviewed. More than half of the severely injured children were not from Geneva area. New methods of management have been introduced progressively. The cases are divided in four successive time periods and classified according to their pathology. A continuous improvement in mortality is obvious, decreasing from 29.4% to 2.2%, but climbing again to 15.2% in the last period, probably due to more severe pathologies. For the Geneva area the mortality decreased progressively from 10.4/100 000 to 3.5/100 000 annually, due to better organization and management, but also to a drop in the incidence of severe cases from 35.5–13.5/100 000 per year. A decrease in the number of traffic accidents is responsible for this. However, the number of handicapped children has not changed.