Document Detail

Factors associated with intracranial hypertension in children and teenagers who suffered severe head injuries.
MedLine Citation:
PMID:  20151089     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To analyze factors associated with intracranial hypertension in pediatric patients who suffered severe head injuries. METHODS: Retrospective cohort study, with data collected from September 1998 through August 2003, including patients aged 0 to 16 who suffered severe head injuries, Glasgow score < 9, and submitted to intracranial pressure (ICP) monitoring (n = 132). Intracranial hypertension (IH) was defined as an episode of ICP > 20 mmHg requiring treatment, while refractory IH was ICP over 25 mmHg requiring barbiturates or decompressive craniectomy. Univariate analysis was followed by multivariate analysis; variables were considered significant if p < 0.05. RESULTS: Ages ranged from 2 months to 16 years, median age 9.7 (6.0-2.3) years. Glasgow scores ranged from 3 to 8, median 6 (4-7). Traffic accidents were responsible for 79.5% of events. Monitoring devices were installed, on average, 14 hours after trauma, median time 24 hours. One hundred and three patients (78%) had IH, while 57 (43.2%) had refractory IH. In multivariate analysis, younger age ranges were associated with IH [relative risk = 1.67 (1.03-2.72); p = 0.037], and abnormal postures were associated with refractory IH [relative risk = 2.25 (1.06-4.78)]. The group mortality rate was 51.5%; it was correlated with use of barbiturates in refractory IH and low cerebral perfusion pressure at the intensive care unit. CONCLUSIONS: IH and refractory IH were frequent events in pediatric patients who suffered severe head injuries. The younger the patient, the greater the chance of developing IH. The presence of abnormal postures was found to be a risk factor for refractory IH.
Sérgio Diniz Guerra; Luis Fernando Andrade Carvalho; Carolina Araújo Affonseca; Alexandre Rodrigues Ferreira; Heliane Brant Machado Freire
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Jornal de pediatria     Volume:  86     ISSN:  1678-4782     ISO Abbreviation:  J Pediatr (Rio J)     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-02-12     Completed Date:  2010-10-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985188R     Medline TA:  J Pediatr (Rio J)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  73-9     Citation Subset:  IM    
Ciências da Saúde, Saúde da Criança e do Adolescente, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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MeSH Terms
Age Factors
Brazil / epidemiology
Child, Preschool
Craniocerebral Trauma / physiopathology*
Epidemiologic Methods
Infant, Newborn
Intracranial Hypertension / epidemiology,  etiology*
Posture / physiology

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