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2022, Number 4

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Rev Cubana Pediatr 2022; 94 (4)

Contribution of tomographic findings to the diagnosis of intracranial hypertension in severe traumatic brain injury

Abreu PD, Lacerda GÁ

Language: Spanish
References: 31
Page: 1-20
PDF size: 587.17 Kb.


ABSTRACT

Introduction: Traumatic brain injury is responsible for more than 500,000 visits to the emergency services, 95,000 hospitalizations and 7,000 deaths in children. Clinical monitoring is based on imaging techniques, among others.
Objective: To relate the tomographic findings found, through Marshall's classification at the entrance and diameter of the optic nerve sheath and its association with intracranial pressure and with the results in the pediatric patient with severe head trauma.
Methods: Prospective descriptive study with all pediatric patients suffering from severe head trauma between January 2003 and December 2017.
Results: Of the 41 cases, a relationship was found between the levels of intracranial pressure and the degree of dislocation of the midline >10 mm in 10 patients (62.5%) and with the diameter of the optic nerve sheath (>5.5 mm) by skull tomography in 12 (75.0%); there was also a relationship between these two variables with the results at 6 months of evolution.
Conclusions: The use of simple tomography of the skull as a tool for the determination of variables used in the non-invasive monitoring of intracranial pressure such as Marshall tomographic classification, midline dislocation and measurement of the diameter of the optic nerve sheath, allows to identify increases in intracranial pressure. This could be used for the intensive treatment of pediatric patients with severe head trauma, without the need for invasive monitoring in them.


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