Evaluation of Common Experience of Neurosurgery and Pediatric Intensive Care Unit on Pediatric Head Trauma under the Light of Current Literature: Analysis of 96 Cases

Abstract

Introduction: This study aimed to evaluate the features and injury mechanisms of pediatric head trauma, demographicsof the patients and factors affecting the outcome and to present the common experience of neurosurgery and pediatricintensive care unit (PICU) in light of the current literature.Methods: Ninety-six of 110 children under the age of 18 who had sufficient data and were treated in PICU for head traumabetween 2014 and 2018 were evaluated retrospectively. The association between age, sex, mechanism of injury, neurologicalexamination at presentation, Glasgow coma scale (GCS) score, history of cardiopulmonary resuscitation, shock, bloodglucose level, hypoxia, convulsion, mean arterial pressure, heart rate per minute, body temperature, intracranial pressure(ICP) values, surgical interventions and Glasgow outcome scale (GOS) scores was investigated.Results: There were 32 patients (33.3%) in mild head trauma group, 28 patients (29.1%) in moderate head trauma group and36 patients (37.5%) in severe head trauma group. Isolated head trauma was present in 49 patients, and multitrauma wasobserved in the remaining. The rate of favourable outcome was 72.9% (70 patients), and that of unfavourable outcome was27.1% (26 patients) with the mortality rate of 15.6%. A moderate and negative correlation between presenting GCS scoresand presenting blood glucose levels (rho: -0.422 p<0.001), and a moderate and positive correlation between presenting GCSscores and presenting body temperature were observed (rho: 0.422 p<0.001). A highly significant positive correlation wasobserved between GCS and 1-year GOS scores (rho: 0.762 p<0.001).Discussion and Conclusion: Analyzing the characteristics of pediatric head trauma, knowing the prognostic factors, developinga common algorithm and standardizing the management parallel to current literature will contribute to a favourableprognosis.