Introduction Emerging evidence suggests extra-thoracic trauma may alter the lungs’ responses to infection, increasing the risk of developing pneumonia. It remains unclear if brain trauma increases the risk of pneumonia in children.

Aim We aim to determine the incidence of pneumonia in children with brain trauma requiring intensive care.

Methods A retrospective study was conducted in a single paediatric intensive care unit (PICU) over a 3 year period (between the 1^st of April 2011 and the 31^st of March 2014). 26 patients were admitted to the PICU with isolated brain trauma over the study period. A pre-designed pro forma was used to collect data which included GCS at the scene and in the Emergency Department, duration of stay in the PICU, duration of ventilation, evidence of pneumonia and its timing in relation to the injury, CT head findings, requirement for invasive intracranial pressure (ICP) monitoring and evidence of seizure activity while in the PICU.

Results The median age of patients on admission was 6 years (range: 18 days–14 years 7 months). Median length of stay was 6.5 days (range: 2–16 days). Of the 26 patients studied, 13 had evidence of pneumonia. All of the patients with evidence of pneumonia had stayed in the PICU for more than 3 days (p < 0.05, Fisher’s exact test). 15 children had ICP monitoring. 11 of those with ICP monitoring developed pneumonia.

Conclusion Significantly more brain trauma patients who stayed more than 3 days in the PICU or had ICP monitoring developed pneumonia. Further study is required to determine the reasons that these patients are more prone to developing pneumonia.