Diffuse brain swelling in severely head-injured children

A report from the NIH Traumatic Coma Data Bank

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✓ In this study, data were prospectively collected from 753 patients (111 children and 642 adults) with severe head injury and examined for evidence of diffuse brain swelling and its association with outcome. Diffuse brain swelling occurred approximately twice as often in children (aged 16 years or younger) as in adults. A high mortality rate (53%) was found in these children, which was three times that of the children without diffuse brain swelling (16%). Adults with diffuse brain swelling had a mortality rate (46%) similar to that of children, but only slightly higher than that for adults without diffuse brain swelling (39%). When the diagnosis of diffuse brain swelling was expanded to include patients with diffuse brain swelling plus small parenchymal hemorrhages (< 15 cu cm), these mortality rates were virtually unchanged.

Article Information

Address reprint requests to: E. Francois Aldrich, M.D., Division of Neurosurgery E-17, University of Texas Medical Branch, Galveston, Texas 77550.

© AANS, except where prohibited by US copyright law.

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Figures

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    Graph showing mortality rates in traumatic brain-injured patients with diffuse brain swelling (DBS), diffuse brain swelling with or without small parenchymal hemorrhage (DBS ± PH), and without either (“other”). Bars indicate upper and lower 95% confidence limits. Confidence intervals that do not overlap indicate a significant difference at the p = 0.05 level.

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    Life-table analysis for survival of patients with diffuse brain swelling with or without small parenchymal hemorrhage (DBS ± PH) versus all other patients, considering adults and children separately.

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