gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Prognosis factors and evaluation scale in "Shaken Baby Syndrom"

Meeting Abstract

  • corresponding author E. Mireau - Service de Neurochirurgie Pédiatrique, Hôpital Necker Enfants Malades - Paris
  • M. Zerah - Service de Neurochirurgie Pédiatrique, Hôpital Necker Enfants Malades - Paris
  • E. Hirsch - Service de Neurochirurgie Pédiatrique, Hôpital Necker Enfants Malades - Paris
  • C. Richoux - Service de Neurochirurgie Pédiatrique, Hôpital Necker Enfants Malades - Paris
  • C. Bremont - Service de Neurochirurgie Pédiatrique, Hôpital Necker Enfants Malades - Paris
  • C. Mignot - Service de Neurochirurgie Pédiatrique, Hôpital Necker Enfants Malades - Paris
  • D. Renier - Service de Neurochirurgie Pédiatrique, Hôpital Necker Enfants Malades - Paris

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP063

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0331.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Mireau et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

The aim of the study was to evaluate the prognosis factors in shaken baby syndrom, to determine the clinical and paraclinical features correleted with bad vital or functional evolution.

Methods

We have analysed 404 cases of shaken baby syndrom, reffered in our department between 1994 and 2004. The mean follow-up was 2,5 years after diagnosis of subdural hematoma. The functional evaluation was performed using the folowing scale : Grade 1: no neurologic trouble ; 2: light mental delay requiring psychometric support ; 3: severe mental delay requiring care in institution ; 4: full cognitive deficit requiring continuous care ; and grade 5: death.

Results

The distribution within the different grades was : Grade 1: 46% 2: 23% 3: 14% 4:7 % 5: 10%. Several factors have been identified as being correlated with bad prognosis : epilepsia during the acute period, status epilepticus, electroencephalogaphic abnormality, cerebral parenchymal hypodensity, hyperdensity of the subdural hematoma, pericerebral vertex hyperdensity, intraocular hemorrhage. From these observations, we have elaborated a simplified prognosis scale (SPS). This SPS ranged between 2 and 10, is the result of addition of a clinical score (1: non neurologic deficit ; 2: seizure ; 3: focal deficit ; 4: intubation required ; 5: status epilepticus) and a scanographic score (1: hypo/isodense hematoma ; 2: mixous with hyperdense component less 1cm ; 3: more 1cm ; 4: hyperdense hematoma ; 5: parenchymal hypodensity) Mortality was nil for SPS less than 6, and 51% for SPS 10; Children were asymptomatics in 80% for SPS 2, and 0% for SPS 10. The distribution within the different evaluation grades was correlated with the SPS level.

Conclusions

At the initial period of the hospitalisation, clinical and scannographic features in a simplified prognosis scale, can give reliable evaluation about the long-term neurologic evolution of shaken baby syndrom.