Pediatric Head Injury

Lee, Keun Woo; Hwang, Sung Kyoo; Sung, Joo Kyung; Hamm, In Suk; Park, Yeun Mook; Kim, Seung Lae

Abstract

Pediatric head injury is a leading cause of disability or death in children. Reducing morbidity and mortality require careful attention to the factors leading to poor prognosis. In this regards authors reviewed the clinical features of pediatric head injury to find out the prognostic factors. From 1992 to 1996, 96 pediatric head injury patients were admitted to our hospital. Seventy eight of them(81.3%) were transferred from the other hospitals. Pedestrian vehicle accident and fall were the leading causes. Clear or drowsy patients account for 42.7 %, stuporous, semicomatose or comatose, 57.3%. Early seizures were noted in 18(18.8%). Outcome were good in 68(70.8%), moderate to severe disability 18(18.8%), vegetative 3(3.1 %), and died 7(7.3%). Consciousness level was the most significantly related with poor prognosis. Radiological deterioration, hematoma or edema, was noted in thirteen patients, and their prognosis was significantly worse than others(p=0.01). Those patients with complications occurred during admission such as pneumonia or electrolyte imbalance showed poorer prognosis (p<0.05). In conclusion outcome of the pediatric head in Jury was significantly related to the initial mentality, worsening of hematoma or edema on follow up CT scan, and complications such as pneumonia and electrolyte imbalance during admission . Early recognition of these factors would contribute to the improvement of the outcome of the pediatric head injury patients.