Document Detail


[Severe pediatric head injuries (I). Epidemiology, clinical manifestations and course].
MedLine Citation:
PMID:  21496963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe the epidemiology, clinical manifestations and evolutive characteristics of pediatric patients with severe head injury (SHI).
MATERIAL AND METHOD: A review was made of the patients admitted to the pediatric intensive care unit (PICU) with SHI between July 1983 and December 2009.
RESULTS: Of the 389 patients with head injuries admitted to the PICU during the study period, 174 (45%) presented SHI. The mean age in this group was of 67±9 months, with a Glasgow Coma Score (GCS) of 5.5±1.8 and a PRISM score of 10.7±6.7. The most frequent etiology of SHI was traffic accidents (56%), though these have decreased significantly in the last decade (58.5% vs 45.3%; P<.001). Twenty-one percent of the patients required evacuation of the lesions detected by computed tomography (CT), and 39% presented severe diffuse encephalic injury (DEI). Seventy-nine percent of the patients in whom intracranial pressure (ICP) was monitored presented intracranial hypertension. Sequelae of clinical relevance were recorded in 59 patients (39%), and proved serious in 64% of the cases. The mortality rate in this patient series was 24.7%. Intracranial hypertension decreased significantly in the last decade (88% vs 54%; P<.05), and clinical recovery has improved (23.3% vs 63.1%; P<.001).
CONCLUSIONS: a) The incidence of traffic accidents has decreased in the last decade in the studied population; b) patients with SHI in which ICP was monitored showed a high incidence of intracranial hypertension; c) morbidity-mortality among pediatric patients with SHI has decreased over the course of the study period.
Authors:
J M López Álvarez; M E Valerón Lemaur; O Pérez Quevedo; J M Limiñana Cañal; A Jiménez Bravo de Laguna; E Consuegra Llapurt; A Morón Saén de Casas; R González Jorge
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Publication Detail:
Type:  English Abstract; Journal Article     Date:  2011-04-14
Journal Detail:
Title:  Medicina intensiva / Sociedad Española de Medicina Intensiva y Unidades Coronarias     Volume:  35     ISSN:  1578-6749     ISO Abbreviation:  Med Intensiva     Publication Date:    2011 Aug-Sep
Date Detail:
Created Date:  2011-07-15     Completed Date:  2011-12-19     Revised Date:  2012-01-18    
Medline Journal Info:
Nlm Unique ID:  9207689     Medline TA:  Med Intensiva     Country:  Spain    
Other Details:
Languages:  spa     Pagination:  331-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier España, S.L. y SEMICYUC. All rights reserved.
Affiliation:
Unidad de Medicina Intensiva Pediátrica, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias, Las Palmas de Gran Canaria, España. jmloal@hotmail.com
Vernacular Title:
Traumatismo craneoencefálico pediátrico grave (I). Epidemiología, clínica y evolución.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Craniocerebral Trauma* / diagnosis,  epidemiology,  etiology
Female
Humans
Injury Severity Score
Male
Retrospective Studies

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