Prognosis of brain stem lesion in children with head injury.
BACKGROUND
Traumatic brain stem lesions (tBSL) in children are thought to be a rare phenomenon. This prospective study analyzed the frequency and significance of such lesions on early magnetic resonance imaging (MRI) after severe head injury, since CT fails to demonstrate these lesions.


METHODS
In 30 consecutive children comatose after head injuries, MRI was performed within 8 days of the injury.


RESULTS
The incidence of tBSL was 60%. When the lesion affected the pons or caudal portions of medulla oblongata bilaterally, mortality was 100%. The presence of tBSL significantly correlated with the duration of coma and the categories of outcome, as indicated by the Glasgow Outcome Score. The frequency and the distribution of tBSL in children were similar to adults.


CONCLUSIONS
Magnetic resonance imaging appears to be of high predictive value after severe pediatric head injuries.
Woischneck
Dieter
D
Klinik für Neurochirurgie, Otto-von-Guericke Universität, Leipziger Strasse 44, 39120 Magdeburg, Germany. bild.neurochirurgie@uni-magdeburg.de
Klein
Susan
S
Reissberg
Steffen
S
Peters
Brigitte
B
Avenarius
Stefan
S
Günther
Gudrun
G
Firsching
Raimung
R
D000293:Adolescent; D000328:Adult; D001479:Basal Ganglia / Q000473:pathology; D001933:Brain Stem / Q000293:injuries / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D003337:Corpus Callosum / Q000473:pathology; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D023261:Glasgow Outcome Scale / Q000706:statistics & numerical data; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods