Kayadibi Yasemin, Ülgen Tekerek Nazan, Yeşilbaş Osman, Tekerek Serhat, Üre Emel, Kayadibi Turgut, Tekcan Şanlı Deniz Esin
Department of Radiology, Van Training and Research Hospital, Van-Turkey.
Department of Pediatric Intensive Care Unit, Van Training and Research Hospital, Van-Turkey.
Ulus Travma Acil Cerrahi Derg. 2020 Mar;26(2):212-221. doi: 10.14744/tjtes.2019.94994.
Pediatric head trauma is the most common presentation to emergency departments. Increased intracranial pressure (ICP) may lead to secondary brain damage in head trauma and early diagnosis of increased ICP is very important. Measurement of optic nerve sheath diameter (ONSD) is a method that can be used for determining increased ICP. In this study, we aimed to evaluate the relationship between optic nerve sheath diameter (ONSD) and Rotterdam computer tomography scores (RCTS) in pediatric patients for severe head trauma.
During January 2017-April 2018, medical records and imaging findings of children aged 0-18 years who underwent computed tomography (CT) imaging for head trauma (n=401) and non-traumatic (convulsions, respiratory disorders, headache) (n=255) complaints, totally 656 patient were evaluated retrospectively. Patients' age, sex, presentation and trauma type (high energy-low energy) were identified. Non-traumatic patients with normal cranial CT findings were considered as the control group. CT findings of traumatic brain injury were scored according to Rotterdam criteria. Patients were divided into groups according to their age as follows: 0-3 years, 3-6 years, 6-12 years and 12-18 years.
In our study, tomographic reference measurements of the ONSD in pediatric cases were presented according to age. There was a statistically significant difference between ONSD of severe traumatic patients and the control group. Correlation between RCTS and ONSD was determined and age-specific cut-off values of ONSD for severe traumatic scores (score 4-5-6) were presented.
In our study, reference ONSDs of the pediatric population for CT imaging was indicated. Our study also showed that ONSD measurement is a parameter that can be used in addition to the RCTS to determine the prognosis of the patient in severe head trauma, by reflecting increased intracranial pressure.
小儿头部创伤是急诊科最常见的病症。颅内压（ICP）升高可能导致头部创伤后的继发性脑损伤，早期诊断ICP升高非常重要。视神经鞘直径（ONSD）测量是一种可用于确定ICP升高的方法。在本研究中，我们旨在评估小儿重症头部创伤患者的视神经鞘直径（ONSD）与鹿特丹计算机断层扫描评分（RCTS）之间的关系。
回顾性评估2017年1月至2018年4月期间因头部创伤（n = 401）和非创伤性（惊厥、呼吸障碍、头痛）（n = 255）症状接受计算机断层扫描（CT）成像的0至18岁儿童的病历和影像结果，共评估656例患者。确定患者的年龄、性别、症状表现和创伤类型（高能量-低能量）。将颅脑CT结果正常的非创伤性患者作为对照组。根据鹿特丹标准对创伤性脑损伤的CT结果进行评分。根据年龄将患者分为以下几组：0至3岁、3至6岁、6至12岁和12至18岁。
在我们的研究中，给出了小儿病例中ONSD的断层扫描参考测量值。重症创伤患者的ONSD与对照组之间存在统计学显著差异。确定了RCTS与ONSD之间的相关性，并给出了重症创伤评分（4-5-6分）的年龄特异性ONSD截断值。
在我们的研究中，指出了小儿人群CT成像的ONSD参考值。我们的研究还表明ONSD测量是一个参数，除RCTS外，还可用于通过反映颅内压升高来确定重症头部创伤患者的预后。
