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Skateboarding Related Accidents Have An Underappreciated Rate of Traumatic Brain Injuries
Erin Ward, MD, Simone Langness, MD, Jonathan Halbach, DO, Katherine Davenport MD, Thangarajah, Hari MD, Stephen Bickler MD, Karen Kling, MD, Timothy Fairbanks, MD. Rady Children's Hospital, UCSD, San Diego, California, USA.

Background: A high impact mechanism is a common criterion for obtaining a CT head (CTH) in pediatric patients. Skateboard related accidents (SRA) may be an under appreciated mechanism of injury (MOI). We aimed to evaluate the rates of intracranial hemorrhage (ICH) and skull fractures in SRA.

Methods: A retrospective review was preformed of all pediatric patients who were evaluated with a CTH following a SRA during a 2011-2013 at a Level 1 pediatric trauma hospital.

Results: 45 SRA were identified, accounting for 6.3% of all patients evaluated for a traumatic brain injury (TBI) with a CTH. Of those 21 had a CT abnormality, 12 had a clinically important TBI (ciTBI) requiring a neurosurgical intervention or greater than two night admission, 5 had a TBI and 4 had a skull fracture. These rates were greater than other recognized high impact mechanisms (Figure 1) while the average GCS and ISS among the MOI were comparable. Helmets were protective but infrequently used. Of the 6 patients (13.3%) who wore a helmet, only 1 skull fracture was identified and all were discharged from the ED, a significant decrease TBI compared to SRA without helmet (p<.05).

Conclusions: SRA are an under appreciated MOI, mechanism alone may warrant a CT scan given the significant rates of ciTBI. Helmets provided significant protection but were infrequently utilized despite mandatory state law.

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