Clinicoradiological and therapeutic considerations in severe diffuse traumatic brain injury in children.
Childs Nerv Syst
; 5(3): 168-71, 1989 Jun.
Article
in En
| MEDLINE
| ID: mdl-2758431
ABSTRACT
Forty-one children with severe head injuries and diffuse brain lesions were selected from a consecutive series of 62 children in traumatic coma (21 focal mass lesions) and studied. According to the CT pattern, two main types of intracranial lesions were considered diffuse axonal injury (DAI) and diffuse brain swelling (DBS). High mortality, due to secondary increases of intracranial pressure (ICP), correlated well with the patterns of severe DBS, absence of perimesencephalic cisterns, and obliteration of the ventricles. However, children with normal CTs, and/or obvious shearing injuries indicative of DAI, had favorable outcomes; there was no mortality if increased ICP was not present. We conclude that although there does not seem to be any routine indications for ICP monitoring in children with pure DAI, early ICP monitoring and aggressive management of increasing ICP should be considered in comatose children with DBS, especially when associated with subarachnoid hemorrhage and respiratory or circulatory failure.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Brain Injuries
Type of study:
Etiology_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Humans
Language:
En
Journal:
Childs Nerv Syst
Journal subject:
NEUROLOGIA
/
PEDIATRIA
Year:
1989
Document type:
Article
Affiliation country:
Italy