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Severe head injury in early infancy: analysis of causes and possible predictive factors for outcome
Elisabetta Marton1, Marina Mazzucco, Ennio Nascimben
1Neurosurgery Department, Padova University, Cà Foncello Hospital, 31100 Treviso, Italy. emarton@libero.it
Insights
Severe traumatic brain injuries (TBI) in infants are often caused by domestic or car accidents. Key factors for better outcomes include avoiding hypoxia, hypotension, and hyperglycemia, alongside managing clotting disorders.
Area of Science:
- Pediatric Neurology
- Trauma Surgery
- Critical Care Medicine
Background:
- Severe traumatic brain injury (TBI) in infants presents unique challenges.
- Understanding causes and prognostic factors is crucial for improving outcomes.
Purpose of the Study:
- To analyze the causes of severe TBI in infants.
- To identify prognostic factors influencing outcomes in severe TBI.
Main Methods:
- Retrospective study of 16 infants (<12 months) with severe TBI over 20 years.
- Evaluation using the Children Coma Scale (CCS).
- Assessment of Glasgow Outcome Scale (GOS) at discharge and 12 months post-discharge.
Main Results:
- Domestic accidents and car accidents were primary causes.
- Positive correlation between 1-year GOS and absence of hypoxia/hypotension, controlled hyperglycemia, and normal clotting.
- Weaker correlation with CCS, early seizures, and ICU length of stay.
Conclusions:
- Early management of physiological parameters (oxygenation, blood pressure, glucose) and coagulation is vital.
- Prognostic factors identified can guide clinical management and research in infant TBI.
Object:
The aim of this study was to analyse the causes and prognostic factors for outcome in severe traumatic brain injuries (TBI) in early infancy.
Materials And Methods:
We present a retrospective study on 16 infants aged less than 12 months observed over the last 20 years in our department for severe brain injury. Infants were evaluated by the Children Coma Scale (CCS). We assessed Glasgow Outcome Scale (GOS) at discharge and at 12 months after discharge.
Conclusions:
The main causes of trauma were domestic accidents followed by car accidents. The highest positive correlation was found between the GOS score at 1 year and the presence of hypoxia and hypotension at admission, the presence of hyperglycaemia at 24 h and the occurrence of major clotting disorders. A significant but weaker correlation was found with the CCS at admission, the occurrence of early post-traumatic seizures and the length of stay in the intensive care unit.
