ABSTRACT
Head injury is the most common cause of child traumatology. However, there exist no treatment guidelines in children having intracranial lesions due to minor or moderate head trauma. There is little knowledge about monitoring, clinical exacerbation risk factors, or optimal duration of hospitalization. The aim of this retrospective study is to find predictive factors in the clinical course of non-severe head trauma in children, and thus to determine an optimal management strategy. Poor clinical progress was observed in only 4 out of 113 children. When there are no clinical signs and no eating disorders, an earlier discharge is entirely appropriate. Nevertheless, persistent clinical symptoms including headache, vomiting, and late onset seizure, especially in conjunction with hemodynamic disorders such as bradycardia, present a risk of emergency neurosurgery or neurological deterioration. Special attention should be paid to extradural hematoma (EDH) of more than 10 mm, which can have the most severe consequences. Clinical aggravation does not necessarily correlate with a change in follow-up imaging. Conversely, an apparent increase in the brain lesion on the scan is not consistently linked to a pejorative outcome.
Subject(s)
Craniocerebral Trauma/diagnosis , Disease Progression , Outcome Assessment, Health Care , Seizures/diagnosis , Vomiting/diagnosis , Cerebral Hemorrhage, Traumatic/diagnosis , Cerebral Hemorrhage, Traumatic/etiology , Cerebral Hemorrhage, Traumatic/therapy , Child , Child, Preschool , Craniocerebral Trauma/complications , Craniocerebral Trauma/diagnostic imaging , Craniocerebral Trauma/therapy , Female , Humans , Infant , Male , Retrospective Studies , Seizures/etiology , Seizures/therapy , Severity of Illness Index , Vomiting/etiology , Vomiting/therapyABSTRACT
Steroids as a foremost therapy are widely used in pediatric optic neuritis (ON). Yet, this treatment is not standardized to date. Some children show a resistance to the classic treatment by steroids. Although plasma exchange (PE) and immunoadsorption (IA) techniques are increasingly being adopted and lead to good results in resistant cases in adult patients, very few studies have shown interest in treating ON when steroids have failed. In this study, we report four observations of children, two of whom are treated by PE and two by IA techniques, describing the treatment protocols together with the side effects observed.
