Delayed deterioration following mild head injury in children.
Delayed deterioration following mild head injury in children.
复制标题
儿童轻度头部受伤后病情延迟恶化。
DOI：
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发表时间：
1984
期刊：
影响因子：
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通讯作者：
J. Wilmink
中科院分区：
文献类型：
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作者：
J. Snoek;J. Minderhoud;J. Wilmink
本文描述了一系列42名儿童，他们在看似轻微或微不足道的头部损伤后，在清醒或无症状期后出现神经系统症状。1978-1981年期间，在神经学工作人员连续治疗的967例2个月至17岁的患者中，这一组占4.34%。只有一名患者有颅内血肿。大多数患者表现为良性短暂综合征，包括惊厥或非惊厥体征，自发和完全恢复。然而，在这一系列病例中，有3例死亡，显然是由于严重和无法控制的单侧或弥漫性脑肿胀，表明这种良性综合征的恶性对应。本文回顾了试图解释这些现象的理论。特别提到了布鲁斯和他的同事关于脑肿胀是一个致病因素的假设。目前还缺乏一个充分的理论来解释其发病机制。结论是，青少年大脑对颅脑损伤的反应方式与成人不同。这意味着在入院政策上采取不同的做法。
A series of 42 children is described who, following a seemingly minor or trivial head injury, developed neurological signs after a lucid or symptom-free period. This group constitutes 4.34 per cent of 967 consecutive patients aged 2 months to 17 years who were seen by members of the neurological staff during the years 1978-1981. Only one patient had an intracranial haematoma. The majority of patients showed a benign transient syndrome consisting of either convulsive or nonconvulsive signs with a spontaneous and full recovery. There were, however, 3 deaths in this series, apparently due to severe and uncontrollable unilateral or diffuse brain swelling, demonstrating the malignant counterpart of this benign syndrome. The theories seeking to explain these phenomena are reviewed. Special reference is made to the hypotheses of Bruce and his associates regarding brain swelling as a causative factor. It is considered that an adequate theory to explain the pathogenesis is still lacking. It is concluded that the juvenile brain responds to cranial trauma in a manner different from the adult brain. This implies a different approach in policy to hospital admission.