Child's Nervous System

, Volume 1, Issue 2, pp 109–114 | Cite as

Outcome in children with severe head injuries

  • Javier Esparza
  • Jaime M-Portillo
  • Maria Sarabia
  • José A. Yuste
  • Ricardo Roger
  • Eduardo Lamas
Original Papers


We present a series of 56 children who suffered severe head injuries, with a Glasgow Coma Score (GCS) of less than 8. The cases were classified according to the type of morphologic lesion on computed tomography (CT) scan. Intracranial pressure (ICP) was monitored in all children in this series. A protocol that included artificial ventilation and other measures of treatment for intracranial hypertension was applied. Results were analyzed according to age, type of lesion, and ICP. The usefulness of the ICP recording and of obtaining a correct classification of lesions using the CT scan is emphasized.

Key words

Head trauma Children CT scan ICP Outcome 


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  1. 1.
    Becker DP, Miller JD, Ward JD, Greenberg RP, Young HF, Sakalas R (1977) The outcome from severe head injury with early diagnosis and intensive management. J Neurosurg 47:491–502Google Scholar
  2. 2.
    Bruce DA, Raphaely RC, Goldberg AI, Zimmerman RA, Bilaniuk LT, Schut L, Kuhl DE (1979) Pathophysiology, treatment and outcome following severe head injury in children. Child's Brain 5:174–191Google Scholar
  3. 3.
    Bruce DA, Alavi A, Bilaniuk L, Dolinskas C, Obrist W, Uzzell B (1981) Diffuse cerebral swelling following head injuries in children: the syndrome of malignant brain edema. J Neurosurg 54:170–178Google Scholar
  4. 4.
    Bruce DA (1982) Clinical reflections of brain stem injury in children. Excerpta Medica, Amsterdam (Advances in neurotraumatology)Google Scholar
  5. 5.
    Cooper PR, Maravilla K, Moody S (1979) Serial computerized tomographic scanning and the prognosis of severe head injury. Neurosurgery 5:566–569Google Scholar
  6. 6.
    Gennarelli TA, Thibault LE (1982) Biomechanics of acute subdural hematoma. J Trauma 22:680–686Google Scholar
  7. 7.
    Gennarelli TA, Spielman GM, Langfitt TW, Gildenberg TL, Harrington T, Jane JA, Marshall LF, Miller JD, Pitts LH (1982) Influence of the type of intracranial lesion on outcome from severe head injury: a multicenter study using a new classification system. J Neurosurg 56:26–32Google Scholar
  8. 8.
    Humphreys RP (1983) Outcome of severe head injury in children. Concepts in pediatric neurosurgery III. Karger, BaselGoogle Scholar
  9. 9.
    Johnston IH, Johnston JA, Jennett B (1970) Intracranial pressure changes following head injury. Lancet I: 433–436Google Scholar
  10. 10.
    Klages G (1982) Monitoring of intracranial pressure in comparison to other clinical data in judgement of the course of severe head-injured children. Monogr Paediatr 15:88–91Google Scholar
  11. 11.
    Langfitt TW, Gennarelli TA (1982) Can the outcome from head injury be improved? J Neurosurg 56:19–25Google Scholar
  12. 12.
    Lobato RD, Cordobés F, Rivas JA, De la Fuente M, Montero A, Bárcena A, Pérez C, Cabrera A, Lamas E (1983) Outcome from severe head injury related to the type of intracranial lesion. A computerized tomography study. J Neurosurg 59:762–774Google Scholar
  13. 13.
    Miller J (1977) Significance of intracranial hypertension in severe head injury. J Neurosurg 47:503–516Google Scholar
  14. 14.
    Narayan RK, Greenberg RP, Miller JD (1981) Improved confidence of outcome prediction in severe head injury. A comparative analysis of the clinical examination, multimodality evoked potentials, CT scanning, and intracranial pressure. J Neurosurg 54:751–762Google Scholar
  15. 15.
    Ommaya AK, Gennarelli TA (1976) A physiopathologic basis for noninvasive diagnosis and prognosis of head injury severity. Head injuries. Grune & Stratton, New YorkGoogle Scholar
  16. 16.
    Papo I, Caruselli G, Luongo A (1982) Intracranial pressure in children and adolescents with severe head injuries. Monogr Paediatr 15:75–78Google Scholar
  17. 17.
    Raimondi AJ, Hirschauer J (1984) Head injury in the infant and toddler. Coma scoring and outcome scale. Child's Brain 11:12–35Google Scholar
  18. 18.
    Zimmerman RA, Bilaniuk LT, Bruce D, Dolinskas C, Obrist W, Kuhl D (1978) Computed tomography of pediatric head trauma: acute general cerebral swelling. Radiology 126:403–408Google Scholar
  19. 19.
    Zimmerman RA, Bilaniuk LT, Gennarelli T (1978) computed tomography of shearing injuries of the cerebral white matter. Radiology 127:393–396Google Scholar
  20. 20.
    Zimmerman RA, Bilaniuk LT (1979) Computed tomography in diffuse traumatic cerebral injury. Neural trauma. Raven Press, New YorkGoogle Scholar

Copyright information

© Springer-Verlag 1985

Authors and Affiliations

  • Javier Esparza
    • 1
  • Jaime M-Portillo
    • 1
  • Maria Sarabia
    • 1
  • José A. Yuste
    • 2
  • Ricardo Roger
    • 3
  • Eduardo Lamas
    • 1
  1. 1.Pediatric NeurosurgeryHospital InfantilMadridSpain
  2. 2.AnesthesiologyHospital InfantilMadridSpain
  3. 3.NeuroradiologyHospital InfantilMadridSpain

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