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-2-70 10.15844/pedneurbriefs-2-9-9 Cerebral Trauma Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Severe Head Injuries 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 09 1988 01 08 2016 2 9 70 71 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. Clinical predictors of severe head trauma in children

The clinical predictors of severe head trauma in 55 children, 1 to 15 years of age, were compared with CT scan findings at the Dept of Pediatrics, Medical College of Wisconsin and Children’s Hospital of Wisconsin, Milwaukee, WI.

 Severe Head Trauma Focal Neurologic Deficit Glasgow Coma Scale

The clinical predictors of severe head trauma in 55 children, 1 to 15 years of age, were compared with CT scan findings at the Dept of Pediatrics, Medical College of Wisconsin and Children’s Hospital of Wisconsin, Milwaukee, WI. Severity of head trauma was determined according to the presence or absence of clinical variables, including altered mental states, duration of loss of consciousness or 5 min, vomiting, headache, focal neurologic deficit, seizure, and soft-tissue injury. Injury was considered severe if one or more of the following variables were present: altered mental status, increased intracranial pressure, and seizure or focal neurologic deficit. Thirty-seven (84%) of 44 patients with severe head trauma had a positive CT scan. Six (13%) with a Glasgow Coma Scale (GCS) score of 12 or greater had abnormal CT scans. All patients with mild or moderate head trauma had normal CT scans. Historical information and clinical examination were the most accurate predictors for abnormal CT scans regardless of GCS scores. [1]

COMMENT. The GCS may have limited application in the evaluation of acute head trauma in the pediatric population. A classification based on clinical findings more accurately identifies the severity of head trauma and the need for CT scans.

A further clinical objective evaluation of children with acute head injury includes tests of neuropsychological function. Investigators from the Dept Pediatrics, Univ of Maryland, Baltimore, report cognitive deficits immediately after closed head injury in adolescents that may interfere with school, home and peer activities. [2]

 Hennes H Lee M Smith D Sty JR Losek J Clinical predictors of severe head trauma in children Am J Dis Child 1988 Oct 142 10 1045 7 10.1001/archpedi.1988.02150100039021 3177299 Slater EJ Bassett SS Adolescents with closed head injuries. A report of initial cognitive deficits Am J Dis Child 1988 Oct 142 10 1048 51 10.1001/archpedi.1988.02150100042022 3177300