Journal of neurosurgery
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Journal of neurosurgery · Mar 1981
Case ReportsIntratumoral hemorrhage in posterior fossa tumors after ventricular drainage. Report of two cases.
Severe intratumoral hemorrhage in posterior fossa tumors is reported in two children, one with a Grade I astrocytoma, and the other with a medulloblastoma. Fatal bleeding occurred a few hours after insertion of ventricular drainage for preoperative management of obstructive hydrocephalus.
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The relationship between Glasgow Coma Scale (GSC) scores obtained during the 1st week after head injury and outcome at 1 year was analyzed in 170 patients. Seventy-two of 76 patients with initial GCS scores of 3 or 4 lived, and only one had a favorable outcome. Favorable and unfavorable outcomes were almost equally divided when the initial GCS scores were in the intermediate range of 5, 6, or 7. ⋯ Combining 48-hour GCS scores and shift data significantly improves predictive accuracy based only on coma scores. The data obtained by combining GCS scores at 72 hours and 1 week and shift data is marginally significant for improving accuracy of outcome predictions. It is concluded that GCS scores and shift data are highly accurate indicators of outcome in head-injured patients.