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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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Metadata
- 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 › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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