Limits...
Vasospasm in children with traumatic brain injury.

O'Brien NF, Reuter-Rice KE, Khanna S, Peterson BM, Quinto KB - Intensive Care Med (2010)

Bottom Line: Twenty-two children aged 7 months to 14 years with moderate to severe traumatic brain injury as indicated by Glasgow Coma Score </=12 and abnormal head imaging were enrolled.Duration of vasospasm in the anterior circulation was 4 +/- 2 days based on criteria A and 3 +/- 1 days based on criteria B.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.

View Article: PubMed Central - PubMed

Affiliation: Nationwide Children's Hospital, Columbus, OH, 43205, USA. Nicole.Obrien@nationwidechildrens.org

ABSTRACT

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.

Show MeSH

Related in: MedlinePlus

Day of onset (from time of injury) and duration (in days) of vasospasm by criteria A, B, and C in each patient who met at least one criterion for vasospasm
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2837183&req=5

Fig1: Day of onset (from time of injury) and duration (in days) of vasospasm by criteria A, B, and C in each patient who met at least one criterion for vasospasm

Mentions: Mean time to onset of vasospasm in the MCA was 3 ± 1 days based on criterion A and 4 ± 1 days based on criterion B. Mean time to onset of vasospasm in the BA was 2 ± 1 days (Fig. 1). Vasospasm persisted in the MCA for an average of 4 ± 2 days based on criteria A and 3 ± 1 days based on criteria B. Sixty percent of patients who met criterion A had resolution of vasospasm by post-injury day 5. All patients had resolution by post-injury day 11. By criterion B, 63% of patients had resolution of spasm by post-injury day 5. Again, all patients had resolution by post-injury day 11. Basilar artery vasospasm, based on criterion C, persisted for 2 ± 1 days with all patients having resolution by post-injury day 4 (Fig. 1).Fig. 1


Vasospasm in children with traumatic brain injury.

O'Brien NF, Reuter-Rice KE, Khanna S, Peterson BM, Quinto KB - Intensive Care Med (2010)

Day of onset (from time of injury) and duration (in days) of vasospasm by criteria A, B, and C in each patient who met at least one criterion for vasospasm
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2837183&req=5

Fig1: Day of onset (from time of injury) and duration (in days) of vasospasm by criteria A, B, and C in each patient who met at least one criterion for vasospasm
Mentions: Mean time to onset of vasospasm in the MCA was 3 ± 1 days based on criterion A and 4 ± 1 days based on criterion B. Mean time to onset of vasospasm in the BA was 2 ± 1 days (Fig. 1). Vasospasm persisted in the MCA for an average of 4 ± 2 days based on criteria A and 3 ± 1 days based on criteria B. Sixty percent of patients who met criterion A had resolution of vasospasm by post-injury day 5. All patients had resolution by post-injury day 11. By criterion B, 63% of patients had resolution of spasm by post-injury day 5. Again, all patients had resolution by post-injury day 11. Basilar artery vasospasm, based on criterion C, persisted for 2 ± 1 days with all patients having resolution by post-injury day 4 (Fig. 1).Fig. 1

Bottom Line: Twenty-two children aged 7 months to 14 years with moderate to severe traumatic brain injury as indicated by Glasgow Coma Score </=12 and abnormal head imaging were enrolled.Duration of vasospasm in the anterior circulation was 4 +/- 2 days based on criteria A and 3 +/- 1 days based on criteria B.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.

View Article: PubMed Central - PubMed

Affiliation: Nationwide Children's Hospital, Columbus, OH, 43205, USA. Nicole.Obrien@nationwidechildrens.org

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus