title: Prognosis of brain stem lesion in children with head injury.
abstract: 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.
authors.affiliation: Klinik für Neurochirurgie, Otto-von-Guericke Universität, Leipziger Strasse 44, 39120 Magdeburg, Germany. bild.neurochirurgie@uni-magdeburg.de
authors.forename: Dieter
authors.initials: D
authors.lastname: Woischneck
authors.forename: Susan
authors.initials: S
authors.lastname: Klein
authors.forename: Steffen
authors.initials: S
authors.lastname: Reissberg
authors.forename: Brigitte
authors.initials: B
authors.lastname: Peters
authors.forename: Stefan
authors.initials: S
authors.lastname: Avenarius
authors.forename: Gudrun
authors.initials: G
authors.lastname: Günther
authors.forename: Raimung
authors.initials: R
authors.lastname: Firsching
mesh_terms: 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