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• W2019910452 abstract "To describe the epidemiology, clinical manifestations and evolutive characteristics of pediatric patients with severe head injury (SHI). A review was made of the patients admitted to the pediatric intensive care unit (PICU) with SHI between July 1983 and December 2009. Of the 389 patients with head injuries admitted to the PICU during the study period, 174 (45%) presented SHI. The mean age in this group was of 67 ± 9 months, with a Glasgow Coma Score (GCS) of 5.5 ± 1.8 and a PRISM score of 10.7 ± 6.7. The most frequent etiology of SHI was traffic accidents (56%), though these have decreased significantly in the last decade (58.5% vs 45.3%; p < 0.001). Twenty-one percent of the patients required evacuation of the lesions detected by computed tomography (CT), and 39% presented severe diffuse encephalic injury (DEI). Seventy-nine percent of the patients in whom intracranial pressure (ICP) was monitored presented intracranial hypertension. Sequelae of clinical relevance were recorded in 59 patients (39%), and proved serious in 64% of the cases. The mortality rate in this patient series was 24.7%. Intracranial hypertension decreased significantly in the last decade (88% vs 54%; p < 0.05), and clinical recovery has improved (23.3% vs 63.1%; p < 0.001). (a) The incidence of traffic accidents has decreased in the last decade in the studied population; (b) patients with SHI in which ICP was monitored showed a high incidence of intracranial hypertension; (c) morbidity–mortality among pediatric patients with SHI has decreased over the course of the study period. Describir las características epidemiológicas, clínicas y evolutivas de los pacientes pediátricos con traumatismo craneoencefálico grave (TCEG). Revisión de los pacientes ingresados en una unidad de medicina intensiva pediátrica (UMIP) con TCEG en el periodo comprendido entre julio de 1983 y diciembre de 2009. De los 389 pacientes con traumatismo craneoencefálico (TCE) ingresados en nuestra unidad durante el periodo de estudio, presentaron TCEG 174 (45%). La media de edad de este grupo fue 67 ± 9 meses, con una puntuación media en la escala de Glasgow (GCS) de 5,5 ± 1,8 y una puntuación PRISM media de 10,7 ± 6,7. La etiología más frecuente de los TCEG fueron los accidentes de tráfico (56%), aunque en la última década existe una disminución significativa de su incidencia (el 58,5 frente al 45,3%; p < 0,001). Un 21% de los pacientes precisaron evacuación de la lesión objetivada en la TC, objetivándose en un 39% lesión encefálica difusa (LED) grave. Un 79% de los pacientes en los que se monitorizó la presión intracraneal (PIC) presentaron hipertensión intracraneal (HTC). Las secuelas de relevancia clínica se objetivaron en 59 pacientes (39%), siendo graves en el 64% de ellos. La mortalidad de la población estudiada fue de un 24,7%. La incidencia de HTC fue significativamente menor en la última década estudiada (el 88 frente al 54%; p < 0,05), con una mejor recuperación clínica (el 23,3 frente al 63,1%; p < 0,001). a) La incidencia de los accidentes de tráfico disminuyó en la última década en la población estudiada; b) los pacientes con TCEG en los que se monitorizó la PIC presentaron una alta incidencia de HTC, y c) la morbimortalidad de los TCEG pediátricos disminuyó a lo largo del periodo de estudio." @default.
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• W2019910452 date "2011-08-01" @default.
• W2019910452 modified "2023-10-05" @default.
• W2019910452 title "Severe pediatric head injuries (I). Epidemiology, clinical manifestations and course" @default.
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• W2019910452 doi "https://doi.org/10.1016/j.medine.2011.02.002" @default.
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