Is Routine Repeated Head CT Necessary for All Pediatric Traumatic Brain Injury?
- 주제(키워드) Pediatric Traumatic Brain Injury , Head CT
- 발행기관 고려대학교 대학원
- 지도교수 임동준
- 발행년도 2016
- 학위수여년월 2016. 8
- 학위구분 석사
- 학과 대학원 의학과
- 세부전공 신경외과학 전공
- 원문페이지 27 p
- 실제URI http://www.dcollection.net/handler/korea/000000068498
- 본문언어 영어
- 제출원본 000045884608
초록/요약
Objective: Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there have been debates in the indication for repeated CT scans, especially in pediatric patients. Purpose of this study is to evaluate risk factors of progression of hemorrhage on repeated CT and delayed surgical intervention based on the repeated head CT. Methods: Between March 2007 and December 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types and amount of hemorrhage and changes in amount on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results: Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion: We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.
more목차
Abstract ⅰ
Ⅰ. Introduction 1
Ⅱ. Materials and Methods 2
Ⅲ. Results 4
Ⅳ. Discussion 7
Ⅴ. Conclusions 10
References 11
