The commonest initial computerized tomography (CT) finding in head-injured children is bilateral diffuse cerebral swelling. Cerebral blood flow and CT density studies suggest that this swelling is due to cerebral hyperemia and increased blood volume, not to edema. The clinical history, course, and outcome of 63 children with this CT pattern are reviewed. Fourteen children had a Glasgow Coma Scale score of greater than 8; all made a complete recovery and follow-up CT scans were normal. Forty-nine children had Glasgow Coma Scale scores of 8 or less. Fifteen had a history of a lucid period following the initial unconsciousness. One of these children died of delayed brain swelling, the others recovered well with minimal neurological deficit. Thirty-four children were rendered immediately and continuously unconscious. There was a high incidence of second lesions on the CT scan, 50% of this group developed intracranial hypertension and five died. All of the others were in coma for periods ranging from weeks to months. Follow-up CT scans showed an extracerebral collection with a density of cerebrospinal fluid in 27% of the patients, and ventriculomegaly with large sulci in 35%, whereas this pattern was seen only once in those with a lucid period. The difference between those with and without a lucid period is related to the degree of primary diffuse impact injury to the white matter.

To measure the effects of chronic low-level exposure to inorganic mercury, the neuropsychological performances of 13 female dental auxiliary workers with elevated head mercury levels (as measured by an X-ray fluorescence technique) were compared with 13 workers with no measurable mercury levels. Workers with elevated mercury levels scored significantly less well on the Recurrent Figures, and SCL-90-R, but not on the WAIS, Rey's AVL, PASAT, BGT, Grooved Pegboard, and Finger Tapping tests. Chronic subtoxic levels of inorganic mercury appear to produce mild changes in short-term nonverbal recall and heightened distress generally, and particularly in categories of obsessive compulsion, anxiety and psychoticism, without alterations in general intellectual functioning, attention, verbal recall, and motor skills.

Computed tomography (CT) was performed in 26 infants and children with craniocerebral trauma related to abuse during a 41-month period. The pattern of brain injury differed from that seen in the nonabused traumatized infant or child. Parieto-occipital acute interhemispheric subdural hematoma (AIHSH) with associated parenchymal injury was the most frequent finding (58%). Follow-up by CT in patients with AIHSH demonstrated infarction in half and cerebral atrophy in all.

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