Diffuse Brain Injury in Children

Summary

Factors that might have influences on the outcome of children with diffuse brain injury (DEI) were analyzed and compared with those of adult cases. One hundred and twelve patients with DEI, 24 children and 88 adults, were studied. This study indicated that children had a better outcome than adults. Traffic accident was the predominant cause of injury both in children and adults. Pedestrian-injuries were more frequent in children (71%) than in adults (23%). Most patients with hypotension by systemic trauma or severe brainstem injury had a poor outcome, but shocked victims were significantly fewer in children (4%) than in adults (26%). Initial computed tomographic findings were divided into 3 categories proposed by Marshall in 1991. Correlation between types of DEI and outcome was not significant in children, but significant in adults. The relationship between outcome and neurological status on admission was studied in 88 patients without hypotension. Children had a better Glasgow coma scale score and better neurological status than adults. Outcome in adults correlated with GCS and abnormalities of posturing, pupils, and brain stem reflex. But in children, this relationship was not significant except for GCS. These findings suggest that the pathophysiology of DEI in children is different from that in adults.