Related Experiment Video
Updated: Jan 27, 2026
Author Spotlight: Advancing Traumatic Brain Injury Research - A Closed-Head Model for Accurate Replication and Rapid Assessment
Published on: September 22, 2023
Severe head injury in children: experience of the Traumatic Coma Data Bank
H S Levin1, E F Aldrich, C Saydjari
1Division of Neurosurgery, University of Texas Medical Branch, Galveston.
Insights
Severe head injuries in children significantly impact recovery, with outcomes varying by age. Younger children (0-4 years) face the highest mortality, while 5-10 year olds show the best recovery rates.
Area of Science:
- Pediatric Neurotrauma
- Clinical Outcomes Research
- Severe Head Injury Management
Background:
- Severe head injuries in children are a significant cause of morbidity and mortality.
- Understanding factors influencing long-term recovery is crucial for improving patient care.
Purpose of the Study:
- To investigate the outcomes at discharge, 6 months, and 1 year following severe head injuries in children (0-15 years).
- To identify predictors of recovery and analyze age-specific outcomes.
Main Methods:
- Prospective study of 103 children admitted to neurosurgery services across four centers.
- Glasgow Outcome Scale (GOS) used to assess recovery at 6 months and 1 year.
- Analysis included Glasgow Coma Scale, pupillary reactivity, computed tomography (CT) scans, and age-defined subgroups.
Main Results:
- Lowest post-resuscitation Glasgow Coma Scale and pupillary reactivity predicted 6-month GOS.
- Bilateral swelling, midline shift, and mass lesions on CT scans correlated with poor outcomes.
- Mortality was highest (62% by 1 year) in the 0-4 year old group, with evacuated subdural hematomas and hypotension being common.
- The 5-10 year old group had the most favorable outcomes (2/3 good recovery by 1 year).
- Adolescents showed intermediate outcomes between younger children and adults.
Conclusions:
- Age is a critical factor influencing outcomes after severe pediatric head injury.
- Neurological indices and CT scan findings are important predictors of recovery.
- Outcomes are heterogeneous, necessitating age-specific management strategies for severe head injuries in children.
Abstract:
The outcome at discharge, 6 months, and 1 year after they had sustained severe head injuries was investigated in children (0-15 yr old at injury) who were admitted to the neurosurgery service at one of four centers participating in the Traumatic Coma Data Bank. Of 103 eligible children, the quality of recovery was assessed by the Glasgow Outcome Scale (GOS) at 6 months after injury in 92 patients (86% of series) and at 1 year in 82 patients (73% of series). The lowest post-resuscitation Glasgow Coma Scale score and pupillary reactivity were predictive of the 6-month GOS as were their interaction. Analysis of the first computed tomographic scan disclosed that bilateral swelling with/without midline shift was related to a poor outcome as was the presence of mass lesions. Comparison of age-defined subgroups of patients revealed that outcome was poorest in the 0- to 4-year-old patients, as reflected by their mortality, which increased to 62% by 1 year. Distinctive features of the injuries in the 0- to 4-year-olds included evacuated subdural hematomas (20% of patients) and hypotension (32% of patients). The most favorable outcome was attained by 5- to 10-year-olds (2/3 had a good recovery by 1 yr), whereas the GOS distribution of adolescents was intermediate between the children and adults. In summary, the GOS data reflect heterogeneity in the quality of outcome after severe head injury depending on age, neurological indices, and computed tomographic scan diagnostic category.
Related Concept Videos
01:13Data Collection by Experiments
An example of the experimental method is a public...
01:20Traumatic Memory
01:19Muscles that Move the Head
The bilateral sternocleidomastoid, or SCM, and the suprahyoid and infrahyoid muscles are significant head flexors. The SCM muscles originate at the sternum and clavicle and attach to the mastoid process of the temporal bone. The SCM contracts bilaterally to bend the head forward, whereas...
01:12What is an Experiment?
00:59How Data are Classified: Numerical Data
Quantitative data may be either discrete or continuous. All quantitative data that take on only specific numerical...
01:11How Data are Classified: Categorical Data
Data are classified based on whether they are measurable or not. Categorical data cannot be measured; instead, it can be divided into categories. For example, if Y denotes a person's party affiliation, some examples of Y include...