1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-2-35-a 10.15844/pedneurbriefs-2-5-4 Head Trauma and Coma Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Head Injury in Infants and Children http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 05 1988 01 08 2016 2 5 35 35 Copyright: © 1988 The Author(s) 1988 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Head injuries in children under 36 months of age. Demography and outcome

Of 738 children with head injuries (0-16 yrs) admitted to the Children’s Memorial Hospital, Chicago, IL, during a 5-year period from 1981-85, 318 (43%) were less than 3 years of age and almost half of the younger group were under 1 year.

 Head Injuries Motor Vehicle Accident Oculovestibular Reflex

Of 738 children with head injuries (0-16 yrs) admitted to the Children’s Memorial Hospital, Chicago, IL, during a 5-year period from 1981-85, 318 (43%) were less than 3 years of age and almost half of the younger group were under 1 year. A fall was the most common mechanism of injury in children under 3 years, followed by a motor vehicle accident. Post-traumatic seizures developed more commonly in children under 2 yrs (16%) than in older children (9%, entire group). The most reliable indicators of poor outcome were absent or impaired oculovestibular reflex and bilateral fixed dilated pupils. Intracranial pressure greater than 40 torr with coma scores of 3, 4 or 5 spelled fatality. The mortality of the entire group with severe head injury was 22%. [1]

COMMENT: A modified Glasgow Coma Scale — Children’s Coma Scale — was developed as an objective neurological assessment and prognostic indicator for the children under 3 yrs of age in this study. Points for eye-opening responses (4-1) were the same but those for best motor response and best verbal response were different for infants. Smiling, orientation to sound or verbal stimulus, or following objects were given a subscore of “5“ (oriented); consolable crying but inappropriate interaction “4“; inconsistent consolable crying and moaning “3“; inconsolable crying and irritable, restless interaction “2“; no response “1“. One third of the younger group showed a sequence of labile symptoms following the initial loss of consciousness, becoming agitated and irritable, followed by vomiting, sleep, and waking and playful within 24 hrs in the majority. When children were comatose longer than 6 hrs, 75% (12/16) had a poor outcome with a 50% (8/16) mortality.

 Hahn YS Chyung C Barthel MJ Bailes J Flannery AM McLone DG Head injuries in children under 36 months of age. Demography and outcome Childs Nerv Syst 1988 Feb 4 1 34 40 3401866