How should we manage children after mild head injury?

被引:0
|
作者
M. Mandera
T. Wencel
P. Bażowski
J. Krauze
机构
[1] Department of Neurosurgery,
[2] Silesian University School of Medicine,undefined
[3] ul. Medyków 14,undefined
[4] 40-752 Katowice,undefined
[5] Poland e-mail: marekman@mp.pl Fax: +48-32-2525955,undefined
来源
Child's Nervous System | 2000年 / 16卷
关键词
Key words Children; Mild head injury; Outcome; Risk factor; Skull fracture;
D O I
暂无
中图分类号
学科分类号
摘要
There are many controversies concerning the management of children after mild head injury. Most of these patients achieve a full recovery without medical or surgical intervention. A small percentage of them deteriorate owing to intracranial complications. The goal of this study was to identify significant factors that might allow the identification of patients at risk of subsequent deterioration. Its secondary goal was to establish a clinical protocol for the management of mild head injuries in children. We retrospectively reviewed the records of 166 children and adolescents with head trauma who had Glasgow Coma Scale (GCS) or Children Coma Scale (CCS) scores of 13–15 at the time of admission. The patients were divided into five age categories: babies younger than 1 year, children 1–3, 4–6, and 7–14 years old, and adolescents 15–17 years of age. The largest age group consisted of children 7–14 years old (83 cases). There was a male predominance (2:1). The main causes of injury were traffic accidents (55 cases) and falls (53 patients). Neurosurgical procedures were required in 93 of the 166 patients (56%). The most common intracranial lesion was subdural and epidural hematoma (60 cases). In 26 children (15.6%) diffuse brain swelling was the only lesion. A skull fracture was found in 103 cases and was accompanied by epidural hematoma (HED) in 19 cases (18%) and by subdural hematoma (HSD) in 12 cases (12%). However, the 63 children without a fracture also included 18 (29%) who had HSD and 11 (17%) who had HED. In our population 165 (99%) of the patients obtained a very good or good result. None was left severely disabled or in a vegetative state. One patient with GCS 13 died of an infection. We concluded that skull X-ray examination is not sufficient to rule out intracranial hematoma. We recommend CT scanning and admission to hospital for 24-h observation for all children with minor head injury, because of the risk of delayed hematoma.
引用
收藏
页码:156 / 160
页数:4
相关论文
共 50 条
  • [21] Should We Assess Pituitary Function in Children After a Mild Traumatic Brain Injury? A Prospective Study
    Briet, Claire
    Braun, Karine
    Lefranc, Michel
    Toussaint, Patrick
    Boudailliez, Bernard
    Bony, Helene
    FRONTIERS IN ENDOCRINOLOGY, 2019, 10
  • [22] How Should We Manage Peer Review and Why?
    Saxe, Rebecca
    PSYCHOLOGICAL INQUIRY, 2012, 23 (03) : 301 - 302
  • [23] How should we manage anaemia in patients with diabetes?
    Dikow, R
    Schwenger, V
    Schömig, M
    Ritz, E
    NEPHROLOGY DIALYSIS TRANSPLANTATION, 2002, 17 : 67 - 72
  • [24] How should we manage type A aortic dissection?
    Jassar, Arminder S.
    Sundt, Thoralf M., III
    GENERAL THORACIC AND CARDIOVASCULAR SURGERY, 2019, 67 (01) : 137 - 145
  • [25] How Should We Manage a Patient with Masked Hypertension?
    Palatini P.
    High Blood Pressure & Cardiovascular Prevention, 2015, 22 (1) : 11 - 16
  • [26] How should we manage the electronically tagged patient?
    Tye, J
    ANAESTHESIA, 2001, 56 (03) : 295 - 296
  • [27] How should we manage bell's palsy?
    Holten, KB
    JOURNAL OF FAMILY PRACTICE, 2004, 53 (10): : 797 - 798
  • [28] How should we manage an amblyopic patient with cataract?
    Hale, JE
    Murjaneh, S
    Frost, NA
    Harrad, RA
    BRITISH JOURNAL OF OPHTHALMOLOGY, 2006, 90 (02) : 132 - 133
  • [29] HOW SHOULD WE MANAGE A PATIENT WITH UVEAL MELANOMA
    FINE, SL
    ARCHIVES OF OPHTHALMOLOGY, 1985, 103 (07) : 910 - 911
  • [30] How should we manage urban river corridors?
    Lerner, David N.
    Holt, Alison
    18TH BIENNIAL ISEM CONFERENCE ON ECOLOGICAL MODELLING FOR GLOBAL CHANGE AND COUPLED HUMAN AND NATURAL SYSTEM, 2012, 13 : 721 - 729