Clinical Predictors of Progressive Hemorrhagic Injury in Children with Mild Traumatic Brain Injury

Di, Guangfu; Liu, Hua; Jiang, Xiaochun; Dai, Yi; Chen, Sansong; Wang, Zhichun; Liu, Hongyi

doi:10.3389/fneur.2017.00560

Cited by 10 publications

(9 citation statements)

References 24 publications

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“…Despite the higher likelihood of contusion progression compared to other lesions, many studies investigate the phenomenon of 'progressive haemorrhagic injury, ' which represents progression of subarachnoid hemorrhages (SAH), subdural hemorrhages (SDH), and extradural hemorrhages (EDH), in addition to contusions [3,5,[24][25][26][27]; this has resulted in limited appreciation of the risk factors that are specific to the progression of contusions.…”

Section: Introductionmentioning

confidence: 99%

Contusion Progression Following Traumatic Brain Injury: A Review of Clinical and Radiological Predictors, and Influence on Outcome

2020

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Secondary injuries remain an important cause of the morbidity and mortality associated with traumatic brain injury (TBI). Progression of cerebral contusions occurs in up to 75% of patients with TBI, and this contributes to subsequent clinical deterioration and requirement for surgical intervention. Despite this, the role of early clinical and radiological factors in predicting contusion progression remains relatively poorly defined due to studies investigating progression of all types of hemorrhagic injuries as a combined cohort. In this review, we summarize data from recent studies on factors which predict contusion progression, and the effect of contusion progression on clinical outcomes.

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Section: Introductionmentioning

confidence: 99%

Contusion Progression Following Traumatic Brain Injury: A Review of Clinical and Radiological Predictors, and Influence on Outcome

2020

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“…По данным разных источников, ушибы головного мозга возникают примерно в 43% тупой ЧМТ, в трети наблюдений ушибы локализуются по контрударному механизму на противоположной стороне от места травмы [7,25]. Расхождение данных литературы и наших данных, вероятнее всего, связано с тем, что в институте концентрируется значительная часть детей с ЧМТ в остром периоде из регионов, где специализированная нейрохирургическая помощь другими лечебными учреждениями не оказывается или малодоступна.…”

Section: Discussionunclassified

Computed Tomography of Cerebral Contusions in Children Younger Than 3 Years

Zaytseva,

Akhadov,

Mamatkulov

et al. 2024

Innovacionnaâ medicina Kubani

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Background: Cerebral contusions occur in approximately 43% of blunt head trauma cases. The gyri are predominantly affected, although severe traumatic brain injury (TBI) may damage the subcortical white matter and deep structures within the brain. Computed tomography (CT) of the brain is used to evaluate all forms of intracranial injuries, fractures, cerebral edema, and other associated injuries.Objective: To analyze the CT potential in the diagnosis of cerebral contusions during the acute phase of TBI in children younger than 3 years.Materials and methods: In 2021-2022 we performed CT using a Philips Ingenuity Elite 128 slice CT scanner in 1334 children with TBI (730 boys and 604 girls younger than 3 years). The area of interest in the examined children was the skull and cervical spine. We did not use enhancement. The effective dose range varied from 1.27 to 1.91 mSv.Results: Of 510 children, 448 (87.84%) patients had skull fractures that combined with intracranial injuries in 366 (81.7%) children, with 262 (71.58%) of them having severe injuries (Glasgow Coma Scale ≤ 8) and 36 (9.83%) of them undergoing surgery. Cerebral contusions were diagnosed in 58.5% (214 of 366) of children. Contusions (98% of which were hemorrhagic) had different volumes and degrees of hemorrhage and edema. The foci of contusions were in the frontal (37.1%), temporal (34.3%), parietal (20.6%), and, less often, occipital (8%) lobes.Conclusions: CT is the preferred imaging modality in acute TBI, which enables to accurately detect and adequately treat cerebral contusions, preventing secondary injuries. CT is the main diagnostic tool and should be performed in all children with TBI within the first hours after injury.

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“…In Table 3 , we describe the key messages of 32 studies on head CT, 1 2 3 6 15 20 21 22 23 24 25 26 29 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 with the rate of CT use in 19 studies and prevalence of intracranial CT findings in 28 studies. The rate of CT use in children with mTBI ranges from 6.1 to 62%.…”

Section: Epidemiologymentioning

confidence: 99%

“…Other predictors of progressive hematomas are a severe trauma mechanism, CT showing mass effect, multiple intracranial lesions, or an epidural hematoma. 29 45 Often this is not reflected in a lower GCS, 46 and in those cases the vast majority of children do not need surgery. 45…”

Section: Epidemiologymentioning

confidence: 99%

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A Child Presenting with a Glasgow Coma Scale Score of 13: Mild or Moderate Traumatic Brain Injury? A Narrative Review

Hageman

Nihom

2021

Neuropediatrics

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Objective The objective of this article was to compare children with traumatic brain injury (TBI) and Glasgow Coma Scale score (GCS) 13 with children presenting with GCS 14 and 15 and GCS 9 to 12. Data Source We searched PubMed for clinical studies of children of 0 to 18 years of age with mild TBI (mTBI) and moderate TBI, published in English language in the period of 2000 to 2020. Study Selection We selected studies sub-classifying children with GCS 13 in comparison with GCS 14 and 15 and 9 to 12. We excluded reviews, meta-analyses, non-U.S./European population studies, studies of abusive head trauma, and severe TBI. Data Synthesis Most children (>85%) with an mTBI present at the emergency department with an initial GCS 15. A minority of only 5% present with GCS 13, 40% of which sustain a high-energy trauma. Compared with GCS 15, they present with a longer duration of unconsciousness and of post-traumatic amnesia. More often head computerized tomography scans show abnormalities (in 9–16%), leading to neurosurgical intervention in 3 to 8%. Also, higher rates of severe extracranial injury are reported. Admission is indicated in more than 90%, with a median length of hospitalization of more than 4 days and 28% requiring intensive care unit level care. These data are more consistent with children with GCS 9 to 12. In children with GCS 15, all these numbers are much lower. Conclusion We advocate classifying children with GCS 13 as moderate TBI and treat them accordingly.

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Clinical Predictors of Progressive Hemorrhagic Injury in Children with Mild Traumatic Brain Injury

Cited by 10 publications

References 24 publications

Contusion Progression Following Traumatic Brain Injury: A Review of Clinical and Radiological Predictors, and Influence on Outcome

Contusion Progression Following Traumatic Brain Injury: A Review of Clinical and Radiological Predictors, and Influence on Outcome

Computed Tomography of Cerebral Contusions in Children Younger Than 3 Years

A Child Presenting with a Glasgow Coma Scale Score of 13: Mild or Moderate Traumatic Brain Injury? A Narrative Review

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