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RMU

Uruguayan Medical Journal

ISSN: 1688-0390


Vol.20 - Nº 1 - Mar. 2004

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Severe traumatic brain injury in children: interdisciplinary follow up

PÉREZ GONZÁLEZ W; MUÑOZ S; GARCÍA A; DE CASTELLET L; ARIGÓN E; FUENTES A; GONZÁLEZ RABELINO G; REY A; CURBELO G
Rev Med Urug 2004; 20: 44-60
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract

Abstract

Traumatic brain injury is the most frequent cause of neurologic sequelae and death in children. Technology and wider comprehension of physiopathologic processes have contributed to increase survivors rate, who need multidisciplinary and sustaintable rehabilitation.

The group works on the basis of a polivalent protocol follow up program since patients with severe TBI entry in Pediatrics Intensive Care Unit (UCIN).

During four years 50 patients were controlled in an ambulatory way. Median of follow up duration was 20 months. Median of ages was 9 years. Traffic was the most frequent cause of TBI. Other traumatisms were seen in 50% of the group. Fifty percent endured surgical operations; half of them underwent urgent neurosurgery. Initial comma was observed in 95%. More than 90% presented pathologic TBI with fractures, bruise and subarachnoid hemorrhage, as the most frequent.

At released, 78% patients presented severe deficiencies related to the accident. The most frequent were those related to cognitive and locomotive areas. according to the Glasgow Outcome Scale (GOS) 22% of the patients were released from hospital under vegetative state, but showed functional recovery during the following months.

Prevalence of motor and cognitive sequelae decreased, but psychological sequelae increased during follow up.

Three patients died during follow up.

Type of sequelae vary according to fases of follow up, locomotive and psychological sequelae were the most affected in long-term. Persistance of vegetative state was not frequent but was a death risk after onset. GOS was a useful tool to assess neurologic commitment in follow up.