title: Presentations and outcomes of children with intraventricular hemorrhages after blunt head trauma.
abstract: OBJECTIVE
  To describe the clinical presentations and outcomes of children with intraventricular hemorrhages (IVHs) after blunt head trauma (BHT).
  
  
  METHODS
  Subanalysis of a large, prospective, observational cohort study performed from June 1, 2004, through September 31, 2006.
  
  
  METHODS
  Twenty-five emergency departments participating in the Pediatric Emergency Care Applied Research Network. Patients Children presenting with IVH after BHT. Exposure Blunt head trauma.
  
  
  METHODS
  Clinical presentations and outcomes, including the Pediatric Overall Performance Category (POPC) and Pediatric Cerebral Performance Category (PCPC) scores at hospital discharge.
  
  
  RESULTS
  Of 15 907 patients evaluated with computed tomography, 1156 (7.3%) had intracranial injuries. Forty-three of the 1156 (3.7%; 95% CI, 2.7%-5.0%) had nonisolated IVHs (ie, with intracranial injuries on computed tomography), and 10 of 1156 (0.9%; 95% CI, 0.4%-1.6%) had isolated IVHs. Only 4 of 43 (9.3%) of those with nonisolated IVHs had Glasgow Coma Scale (GCS) scores of 14 to 15, and all 10 (100.0%) with isolated IVHs had GCS scores of 15. No patients with isolated IVHs required neurosurgery or died. One patient had moderate overall disability (by the POPC score), and no patient had moderate or severe disability at discharge (by the PCPC score). Of the 43 patients with nonisolated IVHs, however, 16 (37.2%) died and 18 (41.9%) required neurosurgery. In 27 patients (62.8%), injuries ranged from moderate overall disability to brain death by the POPC score.
  
  
  CONCLUSIONS
  Children with nonisolated IVHs after BHT typically present with GCS scores of less than 14, frequently require neurosurgery, and have high mortality rates. In contrast, those with isolated IVHs typically present with normal mental status and are at low risk for acute adverse events and poor outcomes.
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA. rlichenstein@peds.umaryland.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Lichenstein
authors.forename: Todd F
authors.initials: TF
authors.lastname: Glass
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Quayle
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Wootton-Gorges
authors.forename: David H
authors.initials: DH
authors.lastname: Wisner
authors.forename: Michelle
authors.initials: M
authors.lastname: Miskin
authors.forename: J Paul
authors.initials: JP
authors.lastname: Muizelaar
authors.forename: Mohamed
authors.initials: M
authors.lastname: Badawy
authors.forename: Shireen
authors.initials: S
authors.lastname: Atabaki
authors.forename: James F
authors.initials: JF
authors.lastname: Holmes
authors.forename: Nathan
authors.initials: N
authors.lastname: Kuppermann
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020198:Intracranial Hemorrhage, Traumatic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging