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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Review of 1,000 consecutive cases of severe head injury treated before the advent of CT scanning
Turazzi, S., Bricolo, A. P., & Pasut, M. L. (1984) · Acta Neurochirurgica · doi:10.1007/bf01406869 · Cited by 12
Short latency somatosensory-evoked potentials in children —part 3. Findings following head injury
Whittle, I. R., Johnston, I. H., & Besser, M. (1987) · Surgical Neurology · doi:10.1016/0090-3019(87)90104-2 · Cited by 12
Chapter 13. The use of barbiturates in the control of intracranial hypertension in severe pediatric traumatic brain injury
(2003) · Critical Care Medicine · doi:10.1097/00003246-200306006-00014 · Cited by 11
Traumatismo cranioencefálico grave em crianças e adolescentes
de Carvalho, L. F. A., Affonseca, C. D. A., Guerra, S. D., Ferreira, A. R., & Goulart, E. M. A. (2007) · Revista Brasileira de Terapia Intensiva · doi:10.1590/s0103-507x2007000100013 · Cited by 11
Assessment of endocrine functions in children following severe head trauma
Goldman, M., Shahar, E. M., Sack, J., & Meyerovitch, J. (1997) · Pediatric Neurology · doi:10.1016/s0887-8994(97)00168-9 · Cited by 11
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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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Outcome following severe head injuries in children

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