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논문 기본 정보

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학술저널
저자정보
Kim, Won-Hyung (Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine) Lim, Dong-Jun (Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine) Kim, Se-Hoon (Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine) Ha, Sung-Kon (Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine) Choi, Jong-Il (Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine) Kim, Sang-Dae (Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제58권 제2호
발행연도
2015.1
수록면
125 - 130 (6page)

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Objective : Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there is debate the indication for repeated CT scans, especially in pediatric patients. Purpose of our study is to find risk factors of progression on repeated CT and delayed surgical intervention based on the repeated head CT. Methods : Between March, 2007 and December, 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types, amount of hemorrhage and amount changes on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results : Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion : We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.
#Computed tomography #Cranial epidural hemorrhage #Glasgow Coma Scale #Traumatic brain injury

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참고문헌 (24)

참고문헌 신청
Adelson PD. / 2003 / Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Chapter 5. Indications for intracranial pressure monitoring in pediatric patients with severe traumatic brain injury / Pediatr Crit Care Med 4(3 Suppl):S19~S24 google schola Aziz H. / 2013 / Mild and moderate pediatric traumatic brain injury : replace routine repeat head computed tomography with neurologic examination / J Trauma Acute Care Surg 75:550~554 google schola Bata SC. / 2014 / Role of routine repeat head imaging in paediatric traumatic brain injury / ANZ J Surg 84:438~441 google schola Brown CV. / 2004 / Does routine serial computed tomography of the head influence management of traumatic brain injury? A prospective evaluation / J Trauma 57:939~943 google schola Bullock MR. / 2006 / Surgical management of acute epidural hematomas / Neurosurgery 58(3 Suppl):S7~S15 google schola

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