Heart injury in head-injured adolescents

Of 19 adolescents (ages 10-18) admitted consecutively because of major blunt-impact trauma, 15 had head injuries (Glasgow coma scales 4-15). Eight had cardiac injury (42%), as demonstrated by cardiac wall-motion studies utilizing ECG-gated radionuclide angiography. Of the head-injured patients, 7 had cardiac injury (47%), and of these, one died in cardiac shock. Significant cardiac injury is known both experimentally and clinically to escape detection by conventional methods and a compromised cardiac output may bode ill for a damaged brain if cerebral perfusion pressure is in jeopardy.