+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Pathophysiology, treatment and outcome following severe head injury in children

Pathophysiology, treatment and outcome following severe head injury in children

Child's Brain 5(3): 174-191

The pathophysiology and outcome following severe head injury in 85 children are presented. The commonest initial CT diagnosis was of acute brain swelling. This swelling was associated with an increased white matter density on the CT scan which decreased to normal concomitant with recovery and increased ventricular size. CBF measurements in 6 of these patients revealed an increased blood flow despite a decreased CMRO2 and clinical coma. This CT pattern of diffuse swelling is believed to be due to acute cerebrovascular congestion and hyperemia and not to edema. Because of this, all children were treated with endotracheal intubation and controlled hyperventilation as part of the initial management. Mass lesions were uncommon, 20%. ICP was monitored in 40 children. The ICP rose above 20 Torr despite therapy in 80% of children with decerebrate or flaccid coma and in only 20% of children with spontaneous motor function. The ICP was at its highest between the second and fifth day. Aggressive therapy to control the ICP, with barbiturates if necessary, was successful in 80% of the patients. The overall results were useful recovery in 87.5% of the children, 3.5% were left vegetative or severely disabled and 9% died.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 040924163

Download citation: RISBibTeXText

PMID: 456099

DOI: 10.1159/000119817

Related references

Severe head injury--pathophysiology and initial treatment. Harefuah 118(6): 342-343, 1990

Pathophysiology of the severe head injury in children I Acute traumatic intraventricular hemorrhage. Journal of Nippon Medical School 50(6): 899-903, 1983

Using initial computerized tomography of the head to predict outcome in children with severe head injury. Pediatric Research 47(4 Part 2): 53A, 2000

Pathophysiology of the severe head injury in children. Part 1. Acute traumatic intraventricular hemorrhage. Nihon Ika Daigaku Zasshi 50(6): 899-903, 1983

Severe head injury the significance of sudden drops in blood pressure after head injury as well as treatment of severe head injury with controlled hypocapnia. Acta Neurochirurgica 62(1-2): 141, 1982

Is Mechanical Ventilation Mandatory for the Management of Severe Head Injury? Outcome in 53 Medically Managed Severe Head Injury Patients, Without Ventilatory Support: A Prospective Study. Asian Journal of Neurosurgery 13(1): 18-22, 2018

Outcome from severe head injury in children and adolescents. Journal of Neurosurgery 62(2): 194-199, 1985

Analyzing outcome of treatment of severe head injury: A review and update on advancing the use of the Glasgow Outcome Scale. Journal of Neurotrauma 15(8): 587-597, 1998

The outcome with aggressive treatment in severe head injuries. Part II: acute and chronic barbiturate administration in the management of head injury. Journal of Neurosurgery 50(1): 26-30, 1979

Severe head injury in children: early prognosis and outcome. Child's Nervous System 1(3): 158-162, 1985

Severe head injury among children: prognostic factors and outcome. Injury 40(5): 535-540, 2009

Early prediction of outcome after severe head injury in children. Zeitschrift für Kinderchirurgie 39(4): 223-228, 1984

Severe head injury in children: impact of risk factors on outcome. Journal of Trauma 47(1): 33-38, 1999

Rehabilitation in severe head injury in children: Outcome and provision of care. Developmental Medicine & Child Neurology 44(12): 828-837, 2002

The impact of initial management on the outcome of children with severe head injury. Child's Nervous System 18(1-2): 54-60, 2002