MORBIMORTALIDAD DE LOS NIÑOS DE 0.1 A 12 AÑOS CON TRAUMATISMO CRANEOENCEFÁLICO EN LA UNIDAD DE CUIDADOS INTENSIVOS PEDIÁTRICOS DEL HOSPITAL PROVINCIAL VERDI CEVALLOS BALDA DE PORTOVIEJO, NOVIEMBRE 2009-OCTUBRE 2011

Abstract

The traumatic brain injury (TBI) is the functional organ damage or secondary to cranial contents abrupt exchange mechanical energy applied by outsiders. In developed countries the incidence of TBI is approximately 200 per 100,000 children, including that hospitalized patients and deaths from this disease. It is twice as common in males, but this relationship is highest in adolescence. Between 10 to 15% of children hospitalized with TBI have a serious injury, between 33 and 50% of them die and severe TBI who survive often develop a permanent disability. The most frequent cause in children is accidents happen and most commonly severe TBI. The age-dependent pathology after TBI is significantly frequent and children with symptoms or isolated linear fracture will be reassessed by your doctor within 24 hours. The immediate or primary brain injury is caused by the initial forces generated after trauma. Focal lesions such as contusions and hematomas are generated by linear contact forces when the head is hit by a moving object. There would be many ways to classify the TEC, but in a concise and comfortable, the most widely used is the classification by the scale of Glasgow that we documented, either by physical examination in patient status: TCE mild, moderate or severe. The main types of injuries after trauma are: concussion, cerebral contusion, scalp, skull fractures, subdural hematoma, epidural hematoma, intracerebral hematoma, subarachnoid hemorrhage. When the patient arrived with the ECA should make an excellent medical history, physical examination, classified by Glasgow, specialized diagnostic and treatment immediately, if so required to be transferred to the PICU room. Radiological tests are very important, because with them we get the details on how severe head injuries would have been. Among the most important and mandatory to be performed are: Skull Radiography, Computed Tomography head and if you are in the Health Unit Magnetic Resonance study. The diagnosis itself and which must always der notified by the specialist in neurology and in case of not having him by the head of the area. Within the possible sub-diagnosis of TBI are: simple cranial trauma, intracranial hypertension syndrome, intracranial hemorrhage, other associated injuries. Among the possible complications that occur have the immediate post trauma or the period of treatment in the hospital room or in the PICU. These could be classified as neurological, respiratory, gastric, skin and infectious diseases. In the treatment will have to be cautious and give the same depending on the severity of the patient, in summary, the steps are as follows: ABCD, CSV, head to 45 °, Glasgow and control pupils every 2 hours, neurological care, respiratory care, hemodynamic care, careful gastric nursing care of it and always supportive measures for necessary reasons.