Vasospasm in children with traumatic brain injury.

Journal Article (Journal Article)

Objective

To determine the incidence of vasospasm in children who have suffered moderate to severe traumatic brain injury.

Methods

A prospective observational pilot study in a 24-bed pediatric intensive care unit was performed. Twenty-two children aged 7 months to 14 years with moderate to severe traumatic brain injury as indicated by Glasgow Coma Score 120 cm/s were considered to have vasospasm by criterion A. If flow velocity in the MCA was >120 cm/s and the Lindegaard ratio was >3, vasospasm was considered to be present by criterion B. Patients with basilar artery (BA) flow velocity >90 cm/s met criteria for vasospasm in the posterior circulation (criterion C).

Results

In the MCA, 45.5% of patients developed vasospasm based on criterion A and 36.3% developed vasospasm based on criterion B. A total of 18.2% of patients developed vasospasm in the BA by criterion C. Typical day of onset of vasospasm was hospital day 2-3. Duration of vasospasm in the anterior circulation was 4 +/- 2 days based on criteria A and 3 +/- 1 days based on criteria B. Vasospasm in the posterior circulation persisted for 2 +/- 1 days.

Conclusions

Using the adult criteria outlined above to diagnose vasospasm, a significant proportion of pediatric patients who have suffered moderate to severe traumatic brain injury develop vasospasm during the course of their treatment.

Full Text

Duke Authors

Cited Authors

  • O'Brien, NF; Reuter-Rice, KE; Khanna, S; Peterson, BM; Quinto, KB

Published Date

  • April 2010

Published In

Volume / Issue

  • 36 / 4

Start / End Page

  • 680 - 687

PubMed ID

  • 20091024

Pubmed Central ID

  • PMC2837183

Electronic International Standard Serial Number (EISSN)

  • 1432-1238

International Standard Serial Number (ISSN)

  • 0342-4642

Digital Object Identifier (DOI)

  • 10.1007/s00134-009-1747-2

Language

  • eng