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Clinical outcome after head injury in children
1Department of Neurosurgery, University of Essen, Federal Republic of Germany.
Insights
This study followed 178 children with head injuries, finding that initial coma severity significantly impacts recovery. Most children experienced good outcomes, but severe head injuries and prolonged coma negatively affected results.
Area of Science:
- Pediatric Neurology
- Traumatology
Background:
- Head injuries in children are a significant concern.
- Long-term outcomes and prognostic factors require further investigation.
Purpose of the Study:
- To assess the long-term neurological outcomes of pediatric head injuries.
- To identify factors influencing recovery and disability in children.
Main Methods:
- A follow-up study of 178 children under 18 with head injuries treated between 1981-1987.
- Utilized the Brussel Coma Scale and Glasgow Outcome Score for neurological assessment.
- Evaluated outcomes at least 1 year post-injury.
Main Results:
- Overall satisfactory outcomes were observed in 84.3% of pediatric head injury patients.
- Initial coma grade was the primary determinant of outcome.
- Factors like coma duration and advanced age negatively impacted recovery.
- Diffuse brain swelling showed a favorable outcome (85.1%) in contrast to adults.
Conclusions:
- Pediatric head injury outcomes are largely dependent on initial injury severity.
- While many children recover well, severe injuries and prolonged coma pose risks.
- Diffuse brain swelling in children has a better prognosis than in adults.
Abstract:
For at least 1 year we have done a follow-up on 178 children under the age of 18 years with head injuries treated between 1981 and 1987. The Brussel Coma Scale and the Glasgow Outcome Score were used to determine neurological deficits and patient outcome. In children with coma, there was good recovery or moderate disability in 71.4%, severe disability in 6.1%, and death in 22.5%. When all head injuries were taken into consideration, a satisfactory outcome was found in 84.3%, severe disability in 3.3%, and death in 12.4%. The outcome mainly depended on the initial coma grade, but the duration of coma or advanced age were also negative factors for outcome. In 14.8%, intracranial mass lesions showed no significant correlation with outcome. In contrast to adults, diffuse brain swelling had a satisfactory outcome in 85.1%.