Pediatric neurosurgery
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A subset of children with minor head injury is known to develop serious neurological consequences, but identifying this subset has been difficult. In adults, multiple variables such as skull fracture, Glasgow Coma Scale score, unconsciousness, and amnesia are significant factors that determine whether to admit the patient to the hospital and the patient's outcome. As an objective assessment of neurological function, however, the Glasgow Coma Scale has limited usefulness in children, particularly those under 36 months of age. ⋯ Of these, 99 (13.4%) had lesions requiring surgery: 9 had subdural hematomas, 35 had epidural hematomas, 44 had depressed skull fractures, and 11 had other types of lesions. Two children (0.3%) with Glasgow Coma scores of 13 died after subsequent deterioration, 1 of a delayed epidural hematoma, the other of diffuse cerebral edema. Risk factors such as length of unconsciousness, presence of skull fractures, computed tomography findings, posttraumatic seizure, and Glasgow or Children's Coma scores were evaluated for their impact on the patient's outcome.(ABSTRACT TRUNCATED AT 250 WORDS)