Long-Term Outcome of Children with Severe Head Trauma and Prolonged Coma

Abstract
Children (46) with significant head trauma who remained in coma > 24 h were the subjects of this long-term outcome study. Of the 46, 12 (38%) died. The average length of coma in the 34 survivors was 15.5 days. Follow-up ranged from 9 mo.-4 yr (mean 21 mo.). Of the survivors, 29% were normal at follow-up. An additional 53% had mild cognitive or behavioral problems, but 61% of these had evidence of similar problems prior to the injury. Of the survivors, 9% had motor residua but normal intellect and 9% had severe intellectual and motor problems. Children < 2 yr of age had a worse outcome. Despite severe injury and prolonged coma after head trauma, most children do well. Intensive medical and surgical care increases the rate of survival and does not result in a large number of severely disable survivors.

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