Prognostic factors in children with severe diffuse brain injuries: a study of 74 patients.

Abstract:

:Severe diffuse brain injury in children has a devastating influence on their physical and psychological development. This retrospective study was undertaken to analyse the factors that influence outcome in children with such injuries. The short-term outcomes (Glasgow outcome score) of 74 children (age < or =15 years) with severe diffuse brain injury and no focal operable mass lesions on CT scan, admitted between 1992 and 1998 at the National Institute of Mental Health and Neurosciences were analysed. The prognostic factors analysed were age, gender, time after injury to admission, nature of injury, highest post-resuscitation Glasgow coma score (GCS), pupillary reaction, horizontal oculocephalic reflex and CT scan findings. The following factors were found to be independent predictors of poor outcome: GCS 3-5 (p < 0.003), absent verbal response (p < 0.001), motor response score of 1-3 (p < 0.001), absent pupillary reaction (p < 0.001), absent oculocephalic reflex (p < 0.001) and presence of traumatic subarachnoid haemorrhage on CT scan (p < 0.002). These independent variables were then subjected to a stepwise logistic regression analysis, and the most important variables for predicting outcome were oculocephalic reflex and GCS, which together correctly predicted unfavourable outcome with a sensitivity of 79% and a specificity of 65%. An early CT scan or a single CT scan did not have any prognostic significance.

journal_name

Pediatr Neurosurg

journal_title

Pediatric neurosurgery

authors

Pillai S,Praharaj SS,Mohanty A,Kolluri VR

doi

10.1159/000056002

keywords:

subject

Has Abstract

pub_date

2001-02-01 00:00:00

pages

98-103

issue

2

eissn

1016-2291

issn

1423-0305

pii

56002

journal_volume

34

pub_type

杂志文章
  • Complications of chemotherapy in patients with brain and spinal cord tumors.

    abstract::Complications of chemotherapy in pediatric brain tumor patients tend to be acute and short-lived with some special exceptions such as permanent hearing impairment secondary to cisplatin, infertility and an increased risk of second primary neoplasms. Chemotherapy will be better tolerated and probably more effective in ...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000120601

    authors: Allen JC

    更新日期:1991-01-01 00:00:00

  • Unusual Resolution of a depressed skull fracture following repeat head trauma: the two-hit hypothesis?

    abstract::An infant sustained a significant depressed skull fracture from a fall. Before the planned surgical repair of the fracture could be carried out, the child sustained a second fall that led to the complete resolution of the depressed fracture. Mechanisms to explain this unusual phenomenon are discussed. ...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000334279

    authors: Cohen AR,Bahuleyan B,Robinson S

    更新日期:2011-01-01 00:00:00

  • Successful surgical excision of a nondysraphic holodorsal intramedullary lipoma in a 14-month-old child.

    abstract:INTRODUCTION:Nondysraphic intramedullary lipomas of the spinal cord are rare lesions. They are most commonly seen in the second or third decade of life. Their occurrence in the pediatric age group is even rarer. CASE REPORT:The authors describe a 14-month-old child who presented with delayed motor milestones involving...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000334258

    authors: Kumar A,Chandra PS,Bisht A,Garg A,Mahapatra AK,Sharma MC

    更新日期:2011-01-01 00:00:00

  • Treatment of craniosynostosis by distraction osteogenesis.

    abstract:PURPOSE:Craniosynostosis patients treated with one-stage cranioplasty often have bleeding from the dura mater, fluid collection in the extradural space, and poor wound healing due to skin overstretching. To avoid these complications, we began using distraction osteogenesis. To determine the advantages and disadvantages...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000094064

    authors: Akai T,Iizuka H,Kawakami S

    更新日期:2006-01-01 00:00:00

  • Polyostotic monosystemic calvarial and spinal langerhans' cell histiocytosis treated by surgery and chemotherapy.

    abstract::There are several treatment modalities for Langerhans' cell histiocytosis (LCH) of bone, formerly usually referred to as eosinophilic granuloma, including surgery, radiotherapy and chemotherapy. In spinal lesions, surgery is not recommended generally, because of the potential for reconstitution of vertebral height. We...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000069100

    authors: Karagoz Guzey F,Bas NS,Emel E,Alatas I,Kebudi R

    更新日期:2003-04-01 00:00:00

  • Hepatic pseudocyst as a result of ventriculoperitoneal shunts: case report and review of the literature.

    abstract::Hepatic pseudocyst formation is a rare intra-abdominal complication of ventriculoperitoneal shunts. The presence of an intracranial tumor and a history of central nervous system infection are major risk factors for the development of this complication. Hepatic pseudocysts secondary to ventriculoperitoneal shunts can b...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000108795

    authors: Kaplan M,Ozel SK,Akgun B,Kazez A,Kaplan S

    更新日期:2007-01-01 00:00:00

  • Osmotic myelinolysis with malignant cerebellar edema occurring after DDAVP-induced hyponatremia in a child.

    abstract::Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are dire neurological disorders, characterized by severe damage to the myelin sheath of neurons, which typically result from rapid correction or overcorrection of systemic hyponatremia. For many years, both conditions have been considered universal...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000320146

    authors: Ranger A,Szymczak A,Levin S,Salvadori M,Fraser DD

    更新日期:2010-01-01 00:00:00

  • Schwannoma of the tentorium cerebelli in a child. Case report.

    abstract::Intracranial schwannomas not arising from a cranial nerve are very rare. Schwannomas of the dura are even rarer; in the literature, we found only two cases: a schwannoma of the falx and one of the torcula. We report a third case of a 9-year-old girl with a schwannoma of the tentorium cerebelli. The different theories ...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000048371

    authors: Jabbour P,Rizk T,Lahoud GA,Hourani R,Checrallah A,Samaha E,Nohra G,Moussa R,Okais N

    更新日期:2002-03-01 00:00:00

  • Aquaporin Water Channels and Hydrocephalus.

    abstract::The aquaporins (AQPs) are a family of water-transporting proteins that are broadly expressed in mammalian cells. Two AQPs in the central nervous system, AQP1 and AQP4, might play a role in hydrocephalus and are thus potential drug targets. AQP1 is expressed in the ventricular-facing membrane of choroid plexus epitheli...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000452168

    authors: Verkman AS,Tradtrantip L,Smith AJ,Yao X

    更新日期:2017-01-01 00:00:00

  • Cerebral sparganosis in a child.

    abstract::Cerebral sparganosis in childhood is very rare. Until 1996, 2 cases in children up to 15 years of age had been described. We report a case of cerebral sparganosis in a 6-year-old girl who presented with seizures. Sequential brain magnetic resonance imaging scans spaced over 4 months showed a lesion which migrated from...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000121171

    authors: Kim CY,Cho BK,Kim IO,Hwang YS,Wang KC

    更新日期:1997-02-01 00:00:00

  • Patient/family preparation and education for complications and late sequelae of craniopharyngiomas.

    abstract::Craniopharyngiomas are the most common pediatric suprasellar tumor. While they are benign by histology, their location in the brain predisposes craniopharyngiomas to be associated with both acute and chronic neurologic, endocrine, visual, neuropsychologic and psychosocial problems. Because of the complexity of problem...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000120872

    authors: Shiminski-Maher T

    更新日期:1994-01-01 00:00:00

  • An unusual case of traumatic intracranial hemorrhage caused by wakeboarding.

    abstract::Wakeboarding is a relatively new and exciting sporting activity which is similar to water-skiing. While there have been several reports of water-skiing-related injuries, there has been nothing reported in the literature so far concerning injuries in wakeboarding. We present the case of a 14-year-old male who sustained...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000028957

    authors: Chia JK,Goh KY,Chan C

    更新日期:2000-06-01 00:00:00

  • Aplasia Cutis Congenita of the Scalp, Composite Type: The Criticality and Inseparability of Neurosurgical and Plastic Surgical Management.

    abstract:BACKGROUND/AIMS:The object of this report is to review the management of patients having the composite type of aplasia cutis congenita in the context of the relevant literature on this condition. METHODS:Clinical records, neuroimaging and photographic documentation of identified cases of composite type aplasia cutis c...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000442989

    authors: Winston KR,Ketch LL

    更新日期:2016-01-01 00:00:00

  • Change in spinal curvature following release of tethered spinal cord associated with spina bifida.

    abstract::Changes in spinal curvature, scoliosis, kyphosis and lordosis are associated with the growth of patients with myelomeningocele. Previous investigators have stated that progressive developmental scoliosis is related to tethered spinal cord. In order to investigate the relationship of tethered spinal cord release to pro...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000120762

    authors: Reigel DH,Tchernoukha K,Bazmi B,Kortyna R,Rotenstein D

    更新日期:1994-01-01 00:00:00

  • Results of radiosurgery in the management of recurrent and residual medulloblastoma.

    abstract::Between June 1989 and January 1994, 14 patients with recurrent (n = 11) or posttreatment residual (n = 3) medulloblastoma were enrolled in a program to evaluate the efficacy and toxicity of stereotactic radiosurgery (SR). Initial treatment consisted of subtotal surgical resection in 12 patients and complete surgical r...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000120901

    authors: Patrice SJ,Tarbell NJ,Goumnerova LC,Shrieve DC,Black PM,Loeffler JS

    更新日期:1995-01-01 00:00:00

  • Spontaneous resolution of a prepontine arachnoid cyst. Case report and review of the literature.

    abstract::Prepontine arachnoid cysts are rare developmental anomalies that occur almost exclusively in children. The symptomatic child typically suffers from hydrocephalus, visual impairment, endocrine dysfunction and/or cranial neuropathies. Some cysts, however, are discovered incidentally upon prenatal or postnatal imaging fo...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000064394

    authors: Dodd RL,Barnes PD,Huhn SL

    更新日期:2002-09-01 00:00:00

  • Congenital occipital encephalocele with Dabska tumor: report of an unusual case.

    abstract::Encephaloceles arise from developmental defects in neural tube formation. These lesions contain brain and meninges which herniate through a defect in the skull. These may present as isolated malformations or rarely be associated with brain tumors. We hereby discuss a case of an unusual association of an occipital ence...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000339555

    authors: Rumana M,Khursheed N,Ramzan A

    更新日期:2012-01-01 00:00:00

  • Utility of clinical and radiographic findings in the management of traumatic epidural hematoma.

    abstract:BACKGROUND:There are currently no clear guidelines for the management and radiological monitoring of pediatric patients with epidural hematomas (EDH). We aim to compare clinical and radiographic characteristics of pediatric EDH patients managed with observation alone versus surgical evacuation and to describe results o...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000363143

    authors: Flaherty BF,Loya J,Alexander MD,Pandit R,Ha BY,Torres RA,Schroeder AR

    更新日期:2013-01-01 00:00:00

  • Application of signal transduction inhibition as a therapeutic strategy for central nervous system tumors.

    abstract::During the last decade, rapid progress has been made in understanding the molecular pathways underlying the proliferation of both normal and neoplastic cells. The processes by which messages to initiate protein synthesis, cell cycle progression, and even cell death are transmitted from the cell surface or the cytoplas...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000028729

    authors: Pollack IF,Bredel M,Erff M

    更新日期:1998-11-01 00:00:00

  • Pumping the shunt revisited. A longitudinal study.

    abstract::Most cerebrospinal fluid (CSF) shunts employed in the treatment of hydrocephalus include in their designs a pump mechanism that has been used in office practice as an indicator of whether the shunt is functioning properly; however, the pumping characteristics of shunts have been shown to correlate poorly with clinical...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000121100

    authors: Piatt JH Jr

    更新日期:1996-08-01 00:00:00

  • Fully endoscopic supraorbital resection of congenital middle cranial fossa arachnoid cysts: report of 2 cases.

    abstract::Intracranial congenital arachnoid cysts are benign intra-arachnoidal fluid collections with a wall composed of arachnoid cells encompassing a cavity containing a fluid similar to cerebrospinal fluid. This cavity frequently communicates with the subarachnoid space. Arachnoid cysts are reported to account for about 1% o...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000103314

    authors: Kabil MS,Shahinian HK

    更新日期:2007-01-01 00:00:00

  • Pontine extraventricular neurocytoma in a child.

    abstract::Extraventricular neurocytomas mimic central neurocytomas histologically but are located outside the lateral and/or third ventricles. Pontine neurocytomas represent an extremely rare subset of extraventricular neurocytomas, and reports are limited to 2 adults followed under 28 months. The authors present the case of a ...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000351576

    authors: Hawasli AH,Haydon DH,Dahiya S,Smyth MD

    更新日期:2012-01-01 00:00:00

  • Epidural hematoma as a complication of endoscopic biopsy and shunt placement in a patient harboring a third ventricle tumor.

    abstract::Although some complications have been reported when using endoscopic techniques, epidural hematoma (EDH) has rarely been caused. The authors report a case of EDH complicating a concomitant endoscopic biopsy procedure with ventricular shunt placement in a young, 14-year-old boy harboring a third ventricle tumor with a ...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000082301

    authors: Hamlat A,Heckly A,Doumbouya N,Seigneuret E,Brassier G

    更新日期:2004-09-01 00:00:00

  • Do grip and pinch strength predict neurologic complications in children with spina bifida and hydrocephalus?

    abstract:BACKGROUND:Neurological complications occur commonly in children with meningomyelocele and can cause significant morbidity and mortality. An earlier study suggested that acute changes in grip and pinch strength could be used to identify individuals at increased risk for developing a neurological complication. OBJECTIV...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000092356

    authors: Liptak GS,Fried R,Baltus-Hebert E,Eyer Tierney S,Fucile S,Doremus TL

    更新日期:2006-01-01 00:00:00

  • Central pontine myelinolysis in a pediatric head injury patient.

    abstract::Central pontine myelinolysis occurs inconsistently as a complication of severe and prolonged hyponatremia, particularly when corrected too rapidly. It is a concentrated, frequently symmetric, noninflammatory demyelination within the central basis pontis. We describe a head injury patient who suffered this clinical ent...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000315003

    authors: Singh DK,Rastogi M,Husain M

    更新日期:2010-01-01 00:00:00

  • Computerized tomography appearance of accidental infusion of air into the venous sinuses.

    abstract::A needle for intravenous fluid administration in a newborn was accidentally placed in the sagittal sinus and resulted in dural sinus air embolism. CT findings are described and the risks for venous air embolism are discussed. ...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000120606

    authors: Peled N,Blaser SI,Moore A,Harwood-Nash D

    更新日期:1991-01-01 00:00:00

  • Hypothalamic hamartoma associated with Laurence-Moon-Biedl syndrome. Case report and review of the literature.

    abstract::A rare case of a patient with Laurence-Moon-Biedl syndrome associated with hypothalamic hamartoma is described. The English-language literature contains no cases of patients with this association. The clinical manifestations of this syndrome, those of hypothalamic hamartomas, and the appearance of the tumors on magnet...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1159/000120563

    authors: Diaz LL,Grech KF,Prados MD

    更新日期:1991-01-01 00:00:00

  • Pediatric hemifacial spasm: the efficacy of microvascular decompression.

    abstract::Hemifacial spasm (HFS), generally a disease of the elderly, is caused by vascular compression of the seventh nerve. Vascular compression is thought to result from atherosclerotic changes within the vessels of the posterior fossa, and therefore rarely presents in childhood. Here we describe our experience with 12 patie...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000121260

    authors: Levy EI,Resnick DK,Jannetta PJ,Lovely T,Bissonette DJ

    更新日期:1997-11-01 00:00:00

  • Quality of survival among children treated for brain stem glioma.

    abstract::In order to describe the status of long-term survivors of brain stem glioma, neuropsychological and behavioral measures were obtained a median of 2.5 (range 1.5-5.6) years after diagnosis from 16 survivors of 51 consecutively diagnosed children with brain stem glioma between 1983 and 1991. Among 11 children with dorsa...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000120795

    authors: Mulhern RK,Heideman RL,Khatib ZA,Kovnar EH,Sanford RA,Kun LE

    更新日期:1994-01-01 00:00:00

  • Neuroendoscopic third ventriculostomy in patients less than 1 year old.

    abstract::A series of neuroendoscopic third ventriculostomies in children less than 1 year old is reported. Twenty-seven patients underwent the procedure with 21 (77%) failing within a mean of 1.36 months of the procedure. Nineteen were subsequently shunted. The presence or absence of flow through the ventriculostomy and the si...

    journal_title:Pediatric neurosurgery

    pub_type: 杂志文章

    doi:10.1159/000028693

    authors: Buxton N,Macarthur D,Mallucci C,Punt J,Vloeberghs M

    更新日期:1998-08-01 00:00:00