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[The type of coma as prognostic indicator in severe cranial trauma in childhood]
C Amodeo1, G Baracchini-Muratorio, C A Pruneti
1Il Servizio di Anestesia e Rianimazione, Ospedale di Pisa.
Insights
The type of coma, not its length, impacts long-term outcomes in children with severe traumatic brain injury. Neuropsychological testing confirms distinct sequelae evolution based on coma type.
Area of Science:
- Neurology
- Neuroscience
- Pediatric Traumatology
Context:
- Evaluating post-traumatic brain damage in children is crucial for prognosis.
- Previous research highlighted the significance of coma duration and type in head injuries.
Purpose:
- To investigate the influence of coma type on the evolution of sequelae in children with severe closed head injuries.
- To determine if coma type predicts long-term outcomes independently of coma duration and brain damage location.
Summary:
- Thirty children (aged 6-12) with severe closed head injuries and coma were classified using a modified Plum and Posner scale.
- Follow-up included neurological, physical, EEG, CT, and neuropsychological assessments for at least two years.
- Results indicated that coma type significantly influenced the development of sequelae.
Impact:
- This study suggests that classifying coma type is vital for predicting long-term neurological outcomes in pediatric traumatic brain injury.
- Findings emphasize the need for tailored rehabilitation strategies based on coma classification.
Abstract:
Various methods are used by neurologists to evaluate posttraumatic brain damage. The most important and reliable are the length of posttraumatic amnesia and coma. In previous papers we have already described the value of the type of coma in the prognosis of serious head injury in childhood (Baracchini-Muratorio et al. 1985; Pruneti et al. 1985). In this study, 30 children (aged 6-12 years) with serious closed head injury and subsequent coma were evaluated. The children were divided into two groups according to the type of coma, using the Plum and Posner coma classification (1966) modified by Pagni et al. (1974). The children were followed up for at least two years (9 for five years) after the trauma by means of neurological, physical, EEG, CT scan and neuropsychological examinations. The neuropsychological test results confirm the hypothesis of a different evolution of sequelae in relation to the type of coma, independently of length of coma and site of brain damage.