Analysis of risk factors of massive cerebral infarction after craniocerebral injury in children with acute subdural hematoma
10.3969/j.issn.1002-0152.2024.01.002
- VernacularTitle:儿童急性硬膜下血肿继发大面积脑梗死危险因素分析
- Author:
Yue SI
1
;
Yuqian LI
;
Hu LI
;
Yang YANG
;
Linyi LI
;
Yongxiang SHAO
;
Lihong LI
Author Information
1. 中国人民解放军空军军医大学唐都医院急诊科(西安 710032)
- Keywords:
Acute subdural hematoma;
Traumatic brain injury;
Secondary cerebral infarction after craniocerebral injury;
Children;
Massive cerebral infarction;
Risk factor
- From:
Chinese Journal of Nervous and Mental Diseases
2024;50(1):11-16
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze and compare the clinical manifestations and imaging features of children with secondary massive cerebral infarction after acute subdural hematoma(ASDH),and to evaluate its potential risk factors in order to provide evidence for the prevention,early diagnosis and early treatment of secondary massive cerebral infarction after ASDH.Methods The clinical data of children with ASDH aged 4～12 years were retrospectively studied.All the children received routine operation.The diagnosis of post-traumatic secondary massive cerebral infarction(MCI)was based on low-density areas on CT images and clinical signs.Clinical and radiographic findings related to patient outcomes were reviewed and statistically compared.Univariate and multifactor Cox regression analysis was used to evaluate the MCI after operation to obtain the factors affecting MCI.Results A total of 67 cases were included in the study,with 32 cases included in the MCI group and 35 cases included in the non-MCI group.There were significant differences between MCI and non-MCI groups in age(t=2.016,P= 0.048),body mass(t=2.389,P=0.020),multiple injuries(χ2=11.121,P=0.001),GCS(Z=-4.730,P＜0.001),hematoma volume(χ2=12.890,P=0.002),MLS(χ2=12.261,P=0.002)and perioperative shock(χ2= 14.417,P＜0.001).GCS(OR=0.322,P=0.002),perioperative shock(OR=10.992,P=0.007),multiple injury(OR= 6.547,P=0.046)and MLS score(OR= 46.974,P=0.025)were major risk factors for MCI in children with ASDH.Conclusion Perioperative shock,multiple injuries,low GCS and MLS greater than 10mm are risk factors for MCI.The incidence of MCI is significantly increased in children with multiple risk factors.
