Ann-Charlotte Falk1. 1. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. ann-charlotte.falk@karolinska.se
Abstract
INTRODUCTION: Traumatic brain injury is an important cause of morbidity and mortality in children and adolescents. Moderate to severe brain injuries account for approximately 20 % of all brain injuries, and nearly 50 % of the patients experience neuropsychological sequelae due to the injury. The purposes of this study are, firstly, to describe intensive care management of children with a severe brain injury and, secondly, to study the impact of elevated intracranial pressure on outcome. METHODS: A retrospective review of medical records was done. RESULTS: Sixty children were admitted for intensive care during the study period. Seventy-three percent of all children received neurosurgical interventions, 26 children received an intracranial pressure-monitoring device and 14 of those had an elevated intracranial pressure (ICP) >20 mmHg requiring ICP-targeted therapies. Eighty-eight percent of all children reported cognitive impairment at follow-up. No significant correlation was found between the King's Outcome Scale for Childhood Head Injury outcome groups and whether or not the children have had a neurosurgical intervention or were treated with ICP-targeted medical therapies. CONCLUSION: Children receiving rehabilitation after a brain injury during childhood make a moderate to good recovery. No significant correlation was found between outcome and whether or not the child had been treated for elevated intracranial pressure.
INTRODUCTION:Traumatic brain injury is an important cause of morbidity and mortality in children and adolescents. Moderate to severe brain injuries account for approximately 20 % of all brain injuries, and nearly 50 % of the patients experience neuropsychological sequelae due to the injury. The purposes of this study are, firstly, to describe intensive care management of children with a severe brain injury and, secondly, to study the impact of elevated intracranial pressure on outcome. METHODS: A retrospective review of medical records was done. RESULTS: Sixty children were admitted for intensive care during the study period. Seventy-three percent of all children received neurosurgical interventions, 26 children received an intracranial pressure-monitoring device and 14 of those had an elevated intracranial pressure (ICP) >20 mmHg requiring ICP-targeted therapies. Eighty-eight percent of all children reported cognitive impairment at follow-up. No significant correlation was found between the King's Outcome Scale for Childhood Head Injury outcome groups and whether or not the children have had a neurosurgical intervention or were treated with ICP-targeted medical therapies. CONCLUSION:Children receiving rehabilitation after a brain injury during childhood make a moderate to good recovery. No significant correlation was found between outcome and whether or not the child had been treated for elevated intracranial pressure.
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