Maldaun Marcos V C, Zambelli Helder J L, Dantas Venâncio P, Fabiani Renata M, Martins Aline M, Brandão Marcelo B, Lopes Carlos E, Honorato Donizete C
Departamento de Neurocirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP, Brasil.
Arq Neuropsiquiatr. 2002 Dec;60(4):967-70. doi: 10.1590/s0004-282x2002000600015. Epub 2003 Jan 15.
Analysis of 52 pediatric patients with head trauma assisted at Intensive Care Unit; to present considerations about epidemiologic factors of trauma, clinical presentation, tomografic aspects, hemodynamic changes and treatment options of intracranial hypertension; to present considerations about the intracranial pressure (ICP) monitoring.
Retrospective study involving 52 patients with head trauma and 17 patients submitted to a ICP monitoring.
We found a male predominance, mean age 7.75 years-old, main cause was run over (38.5%); 21.2% patients presentd arterial hypotension; 67.3% were considered severe head trauma. According to Marshall tomografic grading we had 19.2% type I, 65.4% type II, 3.8% type III, 3.8% type IV and 7.7% type V. Seizures occurred in 25% children ICP monitoring was made in 32.7% of all patients. Mortality rate was 11.5%. In 58% the maximum ICP level occured at the second day of trauma.
Prognosis was related to severity of trauma, arterial hypotension, Marshall's tomografic gradind III and IV and ICP high values. The ICP monitoring was considered useful to allow the identification and treatment of intracranial hypertension.
分析在重症监护病房接受治疗的52例小儿头部创伤患者；阐述关于创伤的流行病学因素、临床表现、影像学特征、血流动力学变化及颅内高压治疗选择的相关考量；阐述关于颅内压（ICP）监测的相关考量。
回顾性研究，纳入52例头部创伤患者以及17例接受ICP监测的患者。
我们发现男性居多，平均年龄7.75岁，主要致伤原因是碾压（38.5%）；21.2%的患者出现动脉低血压；67.3%被认为是重度头部创伤。根据马歇尔影像学分级，I型占19.2%，II型占65.4%，III型占3.8%，IV型占3.8%，V型占7.7%。25%的儿童发生癫痫，32.7%的所有患者接受了ICP监测。死亡率为11.5%。58%的患者ICP最高值出现在创伤后第二天。
预后与创伤严重程度、动脉低血压、马歇尔影像学分级III级和IV级以及ICP高值相关。ICP监测被认为有助于识别和治疗颅内高压。
