Prognosis of Severe Traumatic Brain Injury Outcomes in Children

Acta Neurochirurgica. Supplement
Semen V MeshcheryakovOlga V Karaseva

Abstract

We aimed to determine prognostic factors that can influence the outcome of severe traumatic brain injury (TBI) in children. One hundred and sixty-nine patients with severe TBI were included. Consciousness was evaluated using the Glasgow Coma Scale (GCS). Severity of concomitant injuries was evaluated using the Injury Severity Score (ISS). Computer tomography (CT) scanning was used on admission and later. Intracranial injuries were classified using the Marshall CT scale. Intracranial pressure (ICP) monitoring took place in 80 cases. Serum samples of 65 patients were tested for S-100β protein and of 43 patients for neuron specific enolase (NSE). Outcomes were evaluated 6 months after trauma using the Glasgow Outcome Scale (GOS). Statistical and mathematical analysis was conducted. The accuracy of our prognostic model was defined in another group of patients (n = 118). GCS, pupil size and photoreaction, ISS, hypotension and hypoxia are significant predictors of outcome of severe TBI in children. CT results complement the forecast significantly. The accuracy of surviving prognosis came to 76% (0.76) in case of S-100β protein level ≤ 0.25 μg/l and NSE level < 19 μg/l. A mathematical model of outcome prognosis was based on discrimina...Continue Reading

Citations

Sep 3, 2021·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Fatima Y IsmailMilos R Ljubisavljevic

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brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

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