Outcome following severe head injuries in children
Abstract
The outcome in 53 children following severe head injury is presented. All children were graded using the Glasgow Coma Scale; 90% made a good recovery or were moderately disabled, and 8% died or were left vegetative. All patients were treated with controlled ventilation and steroids; mannitol, and, if necessary, Nembutal (pentobarbital) were used to maintain the intracranial pressure below 20 torr. With this regimen, only one death occurred due to uncontrollable intracranial hypertension. All patients with a coma scale of 5 or greater recovered well. The worst prognostic sign was the presence of flaccidity: 33% of these patients died or were vegetative. Five of seven patients who were decerebrate or flaccid with bilateral fixed pupils and absent caloric responses made a good recovery or were moderately disabled. The relatively low incidence of mass lesions (23%) and high incidence of diffuse cerebral swelling (34%) suggest a different pathophysiological response of the child's brain to injury, which may play a role in the improved survival of children following severe head injury when compared to adults.
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- Authors
- Bruce, D. A., Schut, L., Bruno, L. A., Wood, J. H., & Sutton, L. N.
- Venue
- Journal of neurosurgery
- Published
- 1978-05
- Volume
- 48
- Issue
- 5
- Pages
- 679-688
- ISSN
- 0022-3085 (ISSN-L)
- OpenAlex
- W1992789129
- Cited by
- 347
- References
- 25
- Citations by year
- 2025: 1 · 2024: 3 · 2022: 1 · 2021: 1 · 2020: 3 · 2018: 3 · 2017: 2 · 2015: 4 · 2014: 2 · 2013: 5 · 2012: 5
- FWCI
- 14.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- severe traumatic brain injury, pediatric traumatic brain injury, Glasgow Coma Scale, prognosis, intracranial pressure, mannitol, corticosteroids, pentobarbital, controlled ventilation, flaccidity, cerebral edema, space-occupying lesions
- MeSH terms
- Adolescent, Adult, Brain Injuries, Child, Coma, Humans, Methods, Neurologic Examination, Prognosis, Time Factors
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