[Analysis of 52 patients with head trauma assisted at pediatric Intensive Care Unit: considerations about intracranial pressure monitoring]

Arq Neuropsiquiatr. 2002 Dec;60(4):967-70. doi: 10.1590/s0004-282x2002000600015. Epub 2003 Jan 15.
[Article in Portuguese]

Abstract

Objectives: 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.

Method: Retrospective study involving 52 patients with head trauma and 17 patients submitted to a ICP monitoring.

Results: 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.

Conclusion: 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.

MeSH terms

  • Child
  • Child, Preschool
  • Craniocerebral Trauma / physiopathology*
  • Craniocerebral Trauma / therapy
  • Female
  • Humans
  • Hypoxia / prevention & control
  • Infant
  • Intensive Care Units, Pediatric*
  • Intracranial Hypertension / diagnosis
  • Intracranial Hypertension / therapy
  • Intracranial Hypotension / prevention & control
  • Intracranial Pressure*
  • Male
  • Monitoring, Physiologic
  • Prognosis
  • Retrospective Studies
  • Trauma Severity Indices