@article{ref1,
title="Outcome following severe head injuries in children",
journal="Journal of neurosurgery",
year="1978",
author="Bruce, D. A. and Schut, L. and Bruno, L. A. and Wood, J. H. and Sutton, L. N.",
volume="48",
number="5",
pages="679-688",
abstract="The outcome in 53 children following severe head injury is presented. All children were graded using the Glasgow Coma Scale; 90% made a good recovery or were moderately disabled, and 8% died or were left vegetative. All patients were treated with controlled ventilation and steroids; mannitol, and, if necessary, Nembutal (pentobarbital) were used to maintain the intracranial pressure below 20 torr. With this regimen, only one death occurred due to uncontrollable intracranial hypertension. All patients with a coma scale of 5 or greater recovered well. The worst prognostic sign was the presence of flaccidity: 33% of these patients died or were vegetative. Five of seven patients who were decerebrate or flaccid with bilateral fixed pupils and absent caloric responses made a good recovery or were moderately disabled. The relatively low incidence of mass lesions (23%) and high incidence of diffuse cerebral swelling (34%) suggest a different pathophysiological response of the child's brain to injury, which may play a role in the improved survival of children following severe head injury when compared to adults.<p /><p>Language: en</p>",
language="en",
issn="0022-3085",
doi="10.3171/jns.1978.48.5.0679",
url="http://dx.doi.org/10.3171/jns.1978.48.5.0679"
}