Post-traumatic bilateral diffuse cerebral swelling.
This study confirms that bilateral diffuse cerebral swelling with or without parenchymal haemorrhages (< 15 cc) is a more common occurrence in the paediatric patients with severe head injury as compared with adults, since the analysed sample represented 42.55% and 20.43% of all paediatric and adult patients with severe head injury recorded in our clinic at the time of the study, respectively. The incidence of patients with diffuse cerebral swelling without parenchymal haemorrhages was found to be 27.65% of paediatric patients and 5.37% of adult patients with severe head injury. Secondary neurological deterioration occurred only in 5 (12.5%) paediatric patients and in 4 (10.5%) adult patients with diffuse cerebral swelling and was not to be found associated with parenchymal haemorrhages. A better outcome was seen in paediatric patients. Mortality rates were 12.5% in paediatric patients and 34.21% in adult patients. Our data also suggest that the mortality rate between paediatric and adult patients with diffuse cerebral swelling without parenchymal haemorrhages was similar (15.38% and 20% in paediatric and adult group, respectively), while the adult patients with diffuse cerebral swelling associated with small intraparenchymal haemorrhages have a worse prognosis than paediatric patients.
Kazan
S
S
Department of Neurosurgery, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
Tuncer
R
R
Karasoy
M
M
Rahat
O
O
Saveren
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000473:pathology*; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000473:pathology*