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Thirty children were treated for near-drowning in the Children's Hospital, University of Helsinki during 1971--1976. The patients were divided into 3 groups according to the prognosis: group I included 13 children (43%) with a favourable prognosis, group II four children (13%) with a less favourable prognosis who developed severe sequelae, and group III 13 children with poor prognosis and in whom the subsequent outcome proved fatal. The surviving children underwent neurological, neurophysiological and psychological examination 6--58 months after the accident. The children in group I had slight neurological or psychological signs, some children presented a lowered intellectual functioning level. The children in group II were tetraplegic, unable to speak and had convulsions. The following factors were important in affecting prognosis: the longer the immersion time, the worse the prognosis. However, prognosis could still be favourable with an immersion-time of 11-20 min. Prognosis was bad if the first pH value was less than 7.00. The arterial oxygen pressure values measured during the treatment did not correlate with the prognosis but a low rectal temperature on admission was usually associated with a bad prognosis. The degree of EEG-disturbance had a prognostic value. However, the follow-up recording correlated better with the prognosis than the recordings during the first 24 hours, after which worsening of the EEG sometimes showed a progressive brain lesion.

ABSTRACT. The average annual incidence of histologically verified medulloblastomas was 5.4×10‐6 among all 4.9 million Nordic children younger than 15 years from 1968 to 1977. The ratio between boys and girls was 2:1. The incidence had no clear seasonal variation and it peaked at 3 to 4 years of age at onset. The rate of survival after 5 years was 17.4%, equal for boys and girls, but highest in the older age groups. Tumor growth accounted for most deaths with lack of local control in 88% of 112 children autopsied. Metastases outside of the central nervous system occurred in only 6 % of the children. Thus, intensification of the treatment should be directed towards the central nervous system.

ABSTRACT. Forty‐four Nordic children surviving from histologically documented medulloblastoma diagnosed before the age of 15 years from 1968 to 1977 were studied by clinical investigations 5–15 years after the time of diagnosis. Thirty percent of the children suffered from major neurologic and/or intellectual late effects impairing their social life. The remaining 70 % of the children had mild or no motor, sensory, or mental dysfunction. In 30–35% of the patients the quality of life and the level of function in school and in professional life were impaired to a higher degree than was expected from the clinical observations. A favourable long term prognosis with regard to neurologic and intellectual function and to quality of life was significantly correlated to age > 10 years at diagnosis, and it was insignificantly associated with biopsy as the only primary surgical intervention and with peri‐operative treatment with corticosteroids. Sex, length of diagnostic delay, and different treatment modalities did not influence the long term prognosis.