Cited by 347Traumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury ResearchTrauma and Emergency Care Studies

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Outcome following severe head injuries in children

Bruce, Derek A., Schut, Luis, Bruno, Leonard A., Wood, James H., Sutton, Leslie N.·1978·Journal of neurosurgery

DOI 10.3171/jns.1978.48.5.0679

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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
Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
Published: 1978-05
Volume: 48
Issue: 5
Pages: 679-688
ISSN: 0022-3085 (ISSN-L)
DOI: 10.3171/jns.1978.48.5.0679
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 › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Health Sciences › Medicine › Clinical Neurology › 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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