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Prognosis of brain stem lesion in children with head injury

Dieter Woischneck1, Susan Klein, Steffen Reissberg

  • 1Klinik für Neurochirurgie, Otto-von-Guericke Universität, Leipziger Strasse 44, 39120 Magdeburg, Germany. bild.neurochirurgie@uni-magdeburg.de

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|March 20, 2003
PubMed

Insights

Traumatic brain stem lesions (tBSL) are common in children with severe head injuries, detected by MRI. These lesions significantly impact coma duration and outcomes, with bilateral pons or medulla lesions leading to 100% mortality.

Area of Science:

  • Pediatric Neurology
  • Neuroradiology
  • Trauma Surgery

Background:

  • Traumatic brain stem lesions (tBSL) are considered rare in pediatric head injuries.
  • Computed tomography (CT) often fails to detect these subtle lesions.
  • Early detection is crucial for predicting outcomes.

Purpose of the Study:

  • To determine the frequency and significance of tBSL in children with severe head injuries.
  • To evaluate the utility of early magnetic resonance imaging (MRI) in identifying tBSL.
  • To compare the incidence and distribution of tBSL in children and adults.

Main Methods:

  • Prospective study of 30 consecutive children with severe head injuries.
  • MRI scans performed within 8 days of injury.
  • Correlation of tBSL findings with coma duration and Glasgow Outcome Score.

Main Results:

  • The incidence of tBSL was found to be 60% in the studied pediatric population.
  • Bilateral lesions in the pons or medulla oblongata were associated with 100% mortality.
  • tBSL presence significantly correlated with longer coma duration and poorer outcomes.

Conclusions:

  • Early MRI is highly valuable for detecting tBSL in pediatric head injuries.
  • The frequency and distribution of tBSL in children resemble those observed in adults.
  • MRI findings aid in predicting patient outcomes after severe head trauma.
Abstract

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