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Unruptured anterior communicating artery aneurysm in a 2-year-old child

Syahrilfazli AJ, Nursharmizam MB, Azizi AB, Zurin AA

Pediatr Neurosurg, 2005 Sep-Oct;41(5):283-4.
PMID: 16195685
Hydrocephalic children presenting to a Malaysian community-based university hospital over an 8-year period

Abdullah J, Naing NN

Pediatr Neurosurg, 2001 Jan;34(1):13-9.
PMID: 11275782

There are few local statistics on the incidence of hydrocephalus and the outcome of hydrocephalic shunts in the South East Asian region. We report a retrospective study on 285 hydrocephalic patients who underwent shunting procedures between 1990 and 1998 at the University Hospital Science Malaysia, a regional referral center. Multiple logistic regression analysis was applied to predict determinants of outcome in relation to the timing of diagnosis, other congenital abnormalities associated with the hydrocephalus, timing of surgery and cortical thickness from CT scan. The relationship of shunt infection was correlated to the age of the patient and surgical procedure. The predictors for developmental outcome reported by this study were age at diagnosis, type of brain abnormalities and gender. Time of operation and cortical thickness did not contribute to the outcome.
The prognostic value of the Glasgow Coma Scale, hypoxia and computerised tomography in outcome prediction of pediatric head injury

Ong L, Selladurai BM, Dhillon MK, Atan M, Lye MS

Pediatr Neurosurg, 1996 Jun;24(6):285-91.
PMID: 8988493

The outcome of 151 children less than 15 years of age and admitted within 24 h of head injury was studied in relation to clinical and computed tomography (CT) scan features. Thirty one (20.5%) had a poor outcome (24 died, 6 were severely disabled at 6 months after injury and 1 was in a persistent vegetative state) while 120 (79.5%) had a good outcome (89 recovered well and 31 were moderately disabled). Factors associated with a poor outcome were Glasgow Coma Scale (GCS) score 24 h following injury, presence of hypoxia on admission and CT scan features of subarachnoid haemorrhage, diffuse axonal injury and brain swelling. GCS scores alone, in the absence of other factors, had limited predictive value. The prognostic value of GCS scores < 8 was enhanced two-to fourfold by the presence of hypoxia. The additional presence of the CT scan features mentioned above markedly increased the probability of a poor outcome to > 0.8, modified only by the presence of GCS scores > 12. Correct predictions were made in 90.1% of patients, indicating that it is possible to estimate the severity of a patient's injury based on a small subset of clinical and radiological criteria that are readily available.
Traumatic Head Injuries from Ceiling Fans at a Pediatric Level I Trauma Center in the United States

Muzyka L, Garza HH, Merheb D, Sanchez J, Tyler-Kabara E, Lawson KA

Pediatr Neurosurg, 2024;59(1):14-19.
PMID: 37980900 DOI: 10.1159/000535335

BACKGROUND/OBJECTIVE: Several studies describe traumatic head injuries caused by ceiling fans in Australia, the Middle East, and Malaysia. Some injuries required neurosurgical intervention, especially those caused by metallic ceiling fans. This study describes traumatic head injuries caused by ceiling fans at a single pediatric level 1 trauma center in the Southern USA.
METHODS: Medical records were retrospectively reviewed for patients under 18 years of age who presented with a traumatic injury to the head from a ceiling fan from January 1, 2008, through December 31, 2021. The cohort of patients meeting all inclusion criteria was identified by querying multiple free-text fields derived from the electronic medical record, followed by a manual record review.
RESULTS: Of 60 children treated for traumatic head injury from a ceiling fan, the median age was 5.7 years and 53% were female. Laceration was the most common injury (80%), followed by scalp swelling/hematoma (20%), contusion (8%), and skull fracture (7%). Two patients (3%) with intracranial hemorrhage and fracture underwent neurosurgery. One neurosurgical case involved a metal ceiling fan and the other involved an outdoor ceiling fan. Nearly half of the injuries involved bunk or loft beds (47%) and young children were often injured while being lifted up by a caregiver (18%).
CONCLUSION: Although most pediatric traumatic head injuries from ceiling fans resulted in minor injuries, our center saw a similar proportion of cases with skull fractures to what has been reported in Australia (5%). The effects of fan construction and blade material on the severity of head injury may warrant further study. Understanding the most common mechanisms for these injuries may guide injury prevention efforts.