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Reimaging in pediatric neurotrauma: Factors associated with progression of intracranial injury
- Source :
- Journal of Pediatric Surgery. 37:381-385
- Publication Year :
- 2002
- Publisher :
- Elsevier BV, 2002.
-
Abstract
- Purpose: The purpose of this study was to characterize the radiologic changes that are seen in the first 24 to 48 hours after head injury and to correlate those changes with clinical findings, to determine which children are at greatest risk for progression of their neurologic injury. Methods: The authors identified 104 children ([le ]17 years of age) who had a second computed tomography (CT) scan of the head within 24 to 48 hours of admission. CT scans were evaluated systematically in a blinded fashion. Mechanism of injury, findings on physical examination, therapeutic measures, and changes in management were recorded from hospital medical records. The 50 children whose second CT scan showed progression of injury were compared with the 54 patients whose intracranial injuries were unchanged or improved on their second CT. Results: Twenty-six percent of patients (13 of 50) with radiographic progression of injury had an admission Glasgow coma score of 15. Progression of injury was more common, however, in patients with lower Glasgow coma scores, averaging 9 on admission and 10 at the time of the second CT. Progression of injury also was more common if the initial head CT showed 3 or more intracranial injuries, mass effect, intraventricular hemorrhage, or an epidural hematoma. Conclusions: Children with an intracranial injury identified on their initial head CT scan should undergo a second scan 24 hours after injury, especially if the initial CT shows 3 or more intracranial injuries, mass effect, intraventricular hemorrhage, or an epidural hematoma.
- Subjects :
- Hematoma, Epidural, Cranial
Male
medicine.medical_specialty
Adolescent
Physical examination
Injury Severity Score
Hematoma
Epidural hematoma
Head Injuries, Closed
Cerebral Hemorrhage, Traumatic
medicine
Craniocerebral Trauma
Head Injuries, Penetrating
Humans
Glasgow Coma Scale
Prospective Studies
Child
Cranial Nerve Injuries
Retrospective Studies
medicine.diagnostic_test
business.industry
Head injury
Retrospective cohort study
General Medicine
Prognosis
medicine.disease
Intraventricular hemorrhage
Pediatrics, Perinatology and Child Health
Female
Surgery
Radiology
Tomography, X-Ray Computed
business
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....3bf128fa3fd69ae531b7371c1039abf9