ĐẶC ĐIỂM LÂM SÀNG, HÌNH ẢNH CẮT LỚP VI TÍNH VÀ KẾT QUẢ ĐIỀU TRỊ PHẪU THUẬT CHẤN THƯƠNG SỌ NÃO KÍN Ở TRẺ EM

Abstract

Objective: To review the clinical characteristics, CT imaging findings, and treatment outcomes of 52 cases of closed traumatic brain injury in children treated surgically at the National Pediatric Hospital. Methods: This cross-sectional descriptive study includes 52 cases of closed traumatic brain injury in children aged ≤15 years who underwent surgical treatment from January 2023 to January 2024 at the Neurosurgery Department of the National Pediatric Hospital. Results: The average age was 5.56±3 years, with the most common age group being 1-6 years (65.4%). The male-to-female ratio was 1/1. The most frequent cause was traffic accidents (53.9%). Most patients were admitted with a GCS score ≥8. A significant majority showed no signs of focal neurological deficits (78.8%) and no signs of autonomic nervous system involvement (76.9%). Most patients had isolated head injuries. The predominant CT findings were skull fractures (92.3%). The most common types of intracranial injuries were epidural hematomas (75%), followed by subdural hematomas (26.9%). The average hospital stay was 11.83±11.9 days. Of the patients discharged, 83.3% had a GCS score of 13-15. At least 3 months post-treatment, 67.4% of patients had fully recovered, 11.5% had mild sequelae, 11.5% had severe sequelae, 2 patients were in a vegetative state, and 3 patients died. Several factors related to treatment outcomes included preoperative Glasgow score, presence of midline shift on CT, signs of diffuse cerebral edema, brainstem compression, and herniation, with a significance level of p<0.01. Conclusion: The age group most affected is 1-6 years, with the primary cause being traffic accidents. Clinical symptoms upon hospital admission are often atypical. CT findings mainly show skull fractures and epidural hematomas. Surgery is a treatment method that yields relatively good results. Factors such as the GCS score at admission and CT signs like midline shift, cerebral edema, brainstem compression, and herniation are associated with treatment outcomes.