ABSTRACT
Objective To analyze the clinical characteristics of children massive cerebral infarction after traumatic brain injury. Methods The clinical data of 33 children with massive cerebral infarction after traumatic brain injury were retrospectively analyzed. Results Among the 33 children, 24 cases suffered from falling, 10 cases were involved in traffic accidents, 1 case suffered from violence and 1 case was hit by falling object. The massive cerebral infarction occurred in all objects: 9 cases in 1 day after head trauma, 14 cases in 1 - 3 days, 7 cases in 4 - 7 days, and 3 cases after 7 days. Eighteen patients were performed operation to evacuate the intracranial hematoma and decompression. Antiplatelet agents, calcium antagonist and low molecular dextran were administered in all patients after exclusion of bleeding tendency. The follow-up period of all children ranged from 6 months to 24 months. According to Glasgow outcome score (GOS):18 cases showed a good outcome, 6 cases were moderately disabled, 1 case was severely disabled, 1 case survived in a permanent vegetative state and 7 cases died. Conclusions The main causes of children massive cerebral infarction with traumatic brain injury are falling and traffic accident. With proactive treatment, the prognosis of children survivors is acceptable.
ABSTRACT
ObjectiveTo evaluate the mortality and morbility of children with severe traumatic brain injury (sTBI) following treatment with decompressive craniectomy and further analyze its long-term outcomes.Methods Seventeen children with sTBI undergone decompressive craniectomy between 2004 and 2010 were retrospectively studied.Quality of life of the patients who survived the operation was assessed by using the King' s outcome scale for childhood head injury (KOSCHI).ResultsOf 17 children with sTBI,the mean preoperative Glasgow Coma Scale (GCS) score was 5.27.Five children (29％) died postoperatively,of whom three children were died of cerebral infarction.Twelve children who survived the operation were followed up for average 4.6 years,which showed the mean KOSCHI score of 4.75.Among the 12 survivors,five patients (42％) experienced posttraumatic shunt-dependent hydrocephalus and four (33％) suffered ipsilateral and/or contralateral hygroma.ConclusionsAlthough a high mortality rate is observed in the children with sTBI after decompressive craniectomy,the survived patients have satisfactory outcomes. Posttraumatic hydrocephalus and hygroma are two common complications after decompressive craniectomy for children with sTBI.