Impact of elevated ICP on outcome after paediatric traumatic brain injury requiring intensive care

Childs Nerv Syst. 2012 Jul;28(7):1069-75. doi: 10.1007/s00381-012-1772-2. Epub 2012 May 10.

Abstract

Introduction: Traumatic brain injury is an important cause of morbidity and mortality in children and adolescents. Moderate to severe brain injuries account for approximately 20 % of all brain injuries, and nearly 50 % of the patients experience neuropsychological sequelae due to the injury. The purposes of this study are, firstly, to describe intensive care management of children with a severe brain injury and, secondly, to study the impact of elevated intracranial pressure on outcome.

Methods: A retrospective review of medical records was done.

Results: Sixty children were admitted for intensive care during the study period. Seventy-three percent of all children received neurosurgical interventions, 26 children received an intracranial pressure-monitoring device and 14 of those had an elevated intracranial pressure (ICP) >20 mmHg requiring ICP-targeted therapies. Eighty-eight percent of all children reported cognitive impairment at follow-up. No significant correlation was found between the King's Outcome Scale for Childhood Head Injury outcome groups and whether or not the children have had a neurosurgical intervention or were treated with ICP-targeted medical therapies.

Conclusion: Children receiving rehabilitation after a brain injury during childhood make a moderate to good recovery. No significant correlation was found between outcome and whether or not the child had been treated for elevated intracranial pressure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Brain Injuries / complications*
  • Child
  • Child, Preschool
  • Critical Care / methods*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Intracranial Hypertension / etiology*
  • Intracranial Hypertension / therapy*
  • Male
  • Monitoring, Physiologic
  • Neurosurgery / methods*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome