CHIARETTI A, TORTOROLO L, MEŠTROVIĆ J, PIASTRA M, POLIDORI G

 Objectives: To analyze the children admitted to our Pediatric Intensive Care Unit (PICU) for severe neurotrauma and describe the management algorithms adopted by us for pediatric head injury. Methods: All the children affected by severe head injury and admitted to PICU since November 1992 to November 2000 have been examined. Injury severity has been classified using the Glascow Coma Score (GCS), while the long term neurological outcome with the Glascow Outcome Score (GOS). We have described the clinical presentation, the kind and dynamics of injury, the management prior to our admission, the presence of post-traumatic seizures and, finally, the clinical outcome one month after discharge. Results: 122 children with head injury have been identified. The most frequent cause of injury has been represented by car accidents and motorbike or bicycle falls. Patients with severe head injury have presented the following scores: GOS 1 (dead children) 14.7%, GOS 2 (persistent vegetative state) 1.6%, GOS 3 (severe disability) 22.2%, GOS 4 (mild disability) and GOS 5 (no disability) 61.5%. Conclusion: A correct management of children with head injury helps clinicians to improve outcome and to reduce mortality. Therapeutics algorithms suggested by us could be useful for the management of this kind of patients.