电邮这篇文章 Clinical and ultrasonographic evaluation of the neurological status of children with mild brain injury in acute phase
- 作者: Povzun A.A.1,2, Shchugareva L.M.1,2, Iova A.S.1, Kruchina M.K.2, Shulgina M.A.2
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隶属关系:
- North-Western State Medical University n. a. I.I. Mechnikov
- Children’s City Hospital No 1
- 期: 卷 5, 编号 3 (2017)
- 页面: 36-42
- 栏目: Articles
- URL: https://bakhtiniada.ru/turner/article/view/6428
- DOI: https://doi.org/10.17816/PTORS5337-42
- ID: 6428
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详细
Background. The intracranial changes in children with mild traumatic brain injury in acute period are identified by a combination of clinical-neurological and ultrasonographic evaluations of the condition severity.
Aim. The aim of the study was to assess the possibility of performing comprehensive clinical and ultrasonographic evaluations in for determining the severity of the neurological condition of children with mild traumatic brain injury in an acute phase.
Materials and Methods. Clinical and ultrasonographic assessment of the severity of the neurological condition was performed on 256 patients with clinical criteria suggesting mild traumatic brain injury. Ultrasonography was used as the main neuroimaging.
Results. We found that the diagnostic sensitivity of clinical and ultrasonographic examination for detecting traumatic structural intracranial changes in children with mild traumatic brain injury was 90% (95% confidence interval [CI] 0.71–0.98), diagnostic specificity was 97% (95% CI 0.96–0.98), and diagnostic efficiency was 94.9% (95% CI 0.918–0.971).
Conclusions. A comprehensive clinical ultrasonographic approach can be effectively used to assess the severity of the neurological condition of children with mild traumatic brain injury in the acute phase.
作者简介
Andrey Povzun
North-Western State Medical University n. a. I.I. Mechnikov; Children’s City Hospital No 1
编辑信件的主要联系方式.
Email: a.a.povzun@gmail.com
SPIN 代码: 7470-5030
MD, research assistant of the scientific research laboratory “Innovative technologies of medical navigation”; neurologist
俄罗斯联邦, 41, Kirochnaya street, Saint-Petersburg, 191015;14, Avangardnaja street, Saint Petersburg, 198205Lyudmila Shchugareva
North-Western State Medical University n. a. I.I. Mechnikov; Children’s City Hospital No 1
Email: a.a.povzun@gmail.com
MD, PhD, professor at department of children’s neurology and neurosurgery; manageress of the neurology department
俄罗斯联邦, 41, Kirochnaya street, Saint-Petersburg, 191015;14, Avangardnaja street, Saint Petersburg, 198205Alexander Iova
North-Western State Medical University n. a. I.I. Mechnikov
Email: a.a.povzun@gmail.com
MD, PhD, professor of the department of children’s neurology and neurosurgery; head of the scientific research laboratory “Innovative technologies of medical navigation”
俄罗斯联邦, 41, Kirochnaya street, Saint-Petersburg, 191015Marina Kruchina
Children’s City Hospital No 1
Email: a.a.povzun@gmail.com
MD, deputy chief physician for pediatrics
俄罗斯联邦, 14, Avangardnaja street, Saint Petersburg, 198205Maria Shulgina
Children’s City Hospital No 1
Email: a.a.povzun@gmail.com
MD, head of the emergency department
俄罗斯联邦, 14, Avangardnaja street, Saint Petersburg, 198205参考
- Артарян А.А., Иова А.С., Гармашов Ю.А. Черепно-мозговая травма. Клиническое руководство / Под ред. А.Н. Коновалова, Л.Б. Лихтермана, А.А. Потапова. – М.: Антидор, 1998. – С. 603–648. [Artaryan AA, Iova AS, Garmashov YuA. Traumatic Brain Injury. Clinical guildline. A.N. Konovalova, L.B. Likhtermana, A.A. Potapova, editors. Moscow: Antidor; 1998. P. 603–648. (In Russ.)]
- Greenberg JK, Stoev IT, Park TS, et al. Management of children with mild traumatic brain injury and intracranial hemorrhage. Journal of Trauma and Acute Care Surgery. 2014;76(4):1089-1095. doi: 10.1097/ta.0000000000000155.
- Case ME. Accidental traumatic head injury in infants and young children. Brain Pathol. 2008;18(4):583-589. doi: 10.1111/j.1750-3639.2008.00203.x.
- Schunk JE, Rodgerson JD, Woodward GA. The utility of head computed tomographic scanning in pediatric patients with normal neurologic examination in the emergency department. Pediatric Emergency Care. 1996;12(3):160-165. doi: 10.1097/00006565-199606000-00004.
- Щугарева Л.М., Иова А.С., Резнюк Е.А., и др. Совершенствование оказания медицинской помощи детям с легкой черепно-мозговой травмой в условиях многопрофильного стационара // Скорая медицинская помощь. – 2012. – Т. 13. – № 1. – С. 49. [Shchugareva LM, Iova AS, Reznyuk EA, et al. Sovershenstvovanie okazaniya meditsinskoi pomoshchi detyam s legkoi cherepno-mozgovoi travmoi v usloviyakh mnogoprofil’nogo statsionara. Skoraya meditsinskaya pomoshch’. 2012;13(1):49-52. (In Russ.)]
- Brenner DJ, Hall J. Computed tomography — an increasing source of radiation exposure. New England Journal of Medicine. 2007;357(22):2277-2284. doi: 10.1056/nejmra072149.
- Mathews JD, Forsythe AV, Brady Z, et al. Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ: British Medical Journal. 2013;346. doi: 10.1136/bmj.f2360.
- Maguire JL, Boutis K, Uleryk E, et al. Should a head-injured child receive a head CT scan? A systematic review of clinical prediction rules. Pediatrics. 2009;124(1):145-154. doi: 10.1542/peds.2009-0075.
- Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically important brain injuries after head trauma: a prospective cohort study. The Lancet. 2009;374(9696):1160-1170. doi: 10.1016/s0084-3954(10)79686-x.
- Dietrich AM, Bowman MJ, Ginn-Pease ME, et al. Pediatric head injuries: can clinical factors reliably predict an abnormality on computed tomography? Annals of Emergency Medicine. 1993;22(10):1535-1540. doi: 10.1097/00006565-199112000-00030.
- Иова А.С., Крюкова И.А., Иова Д.А. Пансоноскопия при политравме (новая медицинская технология) // Ортопедия, травматология и восстановительная хирургия детского возраста. – 2014. – Т. 2. – № 1. – С. 46–56. [Iova AS, Kryukova IA, Iova DA. Pansonoscopy in polytrauma (New Medical Technology). Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(1):46-56. (In Russ.)] doi: 10.17816/ptors2146-56.
- Иова А.С., Гармашов Ю.А., Андрющенко Н.В., и др. Ультрасонография в нейропедиатрии (новые возможности и перспективы). Ультрасонографический атлас. – СПб.: Петроградский и К°, 1997. – С. 170. [Iova AS, Garmashov YuA, Andryushchenko NV, et al. Ul’trasonografiya v neiropediatrii (novye vozmozhnosti i perspektivy). Ul’trasonograficheskii atlas. Saint Petersburg: Petrogradskii i K°; 1997. (In Russ.)]
- Simpson D, Reilly P. Paediatric coma scale. The Lancet. 1982;320(8295):450. doi: 0.1016/s0140-6736(82)90486-x.
- Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. The Lancet. 1974;304(7872):81-84. doi: 10.1016/s0140-6736(74)91639-0.
- Borg J, Holm L, Cassidy JD, et al. Diagnostic procedures in mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine. 2004;36:61-75. doi: 10.1080/16501960410023822.
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