Suresh H S, Praharaj S S, Indira Devi B, Shukla D, Sastry Kolluri V R
Department of Neurosurgery, NIMHANS, Bangalore-560029, India.
Neurol India. 2003 Mar;51(1):16-8.
The outcome in children with head injury is distinctive because of the different biophysical properties of the child's skull and brain, and their reaction to injury.
In this retrospective study of three hundred and forty children with head injury, managed from January 1993 to December 1998, at NIMHANS, the factors influencing outcome were analyzed.
On admission there were 40 children in GCS 3-5, 55 children in GCS 6-8, 96 in GCS 9-12 and 152 children in GCS 13-15. Eleven patients were under 2 years of age, 53 were between 3-5 years, 140 were between 6-10 years and 156 were between 11-15 years of age. The prognosis in various intracranial pathologies due to head injury was evaluated and outcome assessed at discharge. There were 95 children with EDH and 8.4% had poor outcome (vegetative state or death). There were 85 patients with contusion and poor outcome was noted in 18.8%. One hundred patients had diffuse cerebral oedema on CT scan and outcome was poor in 25% of these patients. The clinical features associated with poor prognosis were, absence of ocular movements (50%), abnormal pupillary size and reaction (49%) and age less than 2 years (27%).
由于儿童颅骨和大脑具有不同的生物物理特性，以及它们对损伤的反应，头部受伤儿童的预后具有特殊性。
在这项对1993年1月至1998年12月在NIMHANS接受治疗的340例头部受伤儿童的回顾性研究中，分析了影响预后的因素。
入院时，格拉斯哥昏迷量表（GCS）评分为3 - 5分的儿童有40例，6 - 8分的有55例，9 - 12分的有96例，13 - 15分的有152例。11例患者年龄在2岁以下，53例在3 - 5岁之间，140例在6 - 10岁之间，156例在11 - 15岁之间。对因头部受伤导致的各种颅内病变的预后进行了评估，并在出院时评估了结局。有95例儿童患有硬膜外血肿（EDH），8.4%的患者预后不良（植物状态或死亡）。有85例患者有脑挫伤，18.8%的患者预后不良。100例患者CT扫描显示弥漫性脑水肿，其中25%的患者预后不良。与预后不良相关的临床特征包括：无眼球运动（50%）、瞳孔大小和反应异常（49%）以及年龄小于2岁（27%）。
