Characteristics of Intracranial Injuries in Pediatric Patients Following Blunt Head Trauma.

Autor:	Akie TE, Gupta M, Rodriguez RM; Department of Emergency Medicine, UCSF School of Medicine, San Francisco, CA., Hendey GW; Department of Emergency Medicine, Ronald Reagan - UCLA Medical Center, Los Angeles., Wilson JL, Quinones AK; Antelope Valley Hospital, Lancaster., Mower WR; Department of Emergency Medicine, Ronald Reagan - UCLA Medical Center, Los Angeles.
Jazyk:	angličtina
Zdroj:	Pediatric emergency care [Pediatr Emerg Care] 2024 Sep 01; Vol. 40 (9), pp. e202-e208. Date of Electronic Publication: 2024 May 15.
DOI:	10.1097/PEC.0000000000003214
Abstrakt:	Objectives: Pediatric head trauma is a frequent reason for presentation to the emergency department. Despite this, there are few reports on specific characteristics and injury patterns in head injured children. The goal of this study was to evaluate head injury patterns in children with blunt head injury and their prevalence by age group. Methods: This is a planned secondary analysis of the NEXUS II Head CT validation study. Consecutive patients with blunt head trauma were enrolled between 2006 and 2015. Demographics and criteria from 2 clinical decision instruments (NEXUS and Canadian Head CT rules) were gathered at the time of enrollment. We abstracted and cataloged injuries for pediatric patients based on radiologist report. Frequencies of injuries and severity were analyzed by developmental age group. Results: A total of 1018 pediatric patients were enrolled, 128 (12.6%) of whom had an injury on computed tomography scan. Median age was 11.9 (Interquartile range 4.5-15.5) for all patients and 12 (4.8-15.5) for injured patients. Of injured patients, 49 (38.3%) had a significant injury, and 27 (21.1%) received an intervention. Teenagers had the highest rate of significant injury (50%) and intervention (30%). Injuries were most frequently noted in the temporal (46.1%), frontal (45.3%), and parietal (45.3%) regions. Subarachnoid hemorrhage (29.7%) and subdural hematoma (28.9%) were the most common injuries observed.Intraparenchymal hemorrhage and cerebral edema were more prevalent in older age groups. The most common injury mechanism overall was fall from height (24.7%). Motor vehicle accidents and nonmotorized wheeled vehicle accidents were more common in older patients. Conclusions: Serious injuries requiring intervention were rarely encountered in pediatric patients experiencing blunt head trauma. Mechanisms of injury, type of injury, and rates of intervention varied between developmental age groups. Competing Interests: Disclosure: The authors declare no conflict of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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