ĐÁNH GIÁ ĐẶC ĐIỂM LÂM SÀNG, HÌNH ẢNH CẮT LỚP VI TÍNH VÀ KẾT QUẢ PHẪU THUẬT CHẤN THƯƠNG SỌ NÃO KÍN CÓ MÁU TỤ NỘI SỌ Ở TRẺ EM

Abstract

Objective: Evaluate the clinical characteristics, computed tomography findings, and surgical treatment outcomes for closed traumatic brain injury with intracranial hematoma in pediatric patients at Saint Paul General Hospital. Methods: A cross-sectional descriptive study was conducted on 47 patients under 18 years of age diagnosed with closed traumatic brain injury and intracranial hematoma, who underwent surgery and were treated at the Department of Neurosurgery, Saint Paul General Hospital from January 1, 2023, to December 31, 2024. Results: Among the 47 pediatric patients included in the study, there was a male predominance with 34 patients (72.34%), nearly three times the number of female patients (13 patients, 27.66%). The mean age of the study group was 13.34 years, with the largest subgroup being patients over 15 years old (23 patients, 48.94%). The primary cause of injury was traffic accidents, accounting for 30 cases (62.5%). The majority of patients presented with symptoms of increased intracranial pressure (85.11%) upon admission. Other common neurological findings included hemiparesis (8.51%), seizures (8.51%), and unilateral mydriasis (10.64%). Regarding computed tomography (CT) findings, epidural hematoma (EDH) was the most frequent, observed in 45 cases (95.74%), while subdural hematoma (SDH) was present in 10 cases (21.28%). The principal surgical procedure was the evacuation of the EDH without dural opening, performed in 43 cases (91.48%). Evacuation of SDH, contusion, or intracerebral hematoma with dural opening was performed in 2 cases (4.26%), and a combined procedure was utilized in 2 cases (4.26%), with bone flap reimplantation in 43 cases (91.48%). Regarding postoperative outcomes, the majority of patients (44 patients, 93.62%) had a good outcome at discharge. At the 6-month follow-up, most patients had made a good recovery without sequelae (91.49%). Conclusion: Traumatic brain injury is more common in male children, with traffic accidents being the leading cause. The primary surgical intervention is the simple evacuation of an epidural hematoma without opening the dura, with reimplantation of the bone flap. The majority of patients achieve a good postoperative recovery.