@entity16 is a significant source of morbidity and mortality in pediatric @entity1 . In order to clarify the factors influencing outcome in pediatric @entity1 with severe @entity542 , we studied 200 consecutive @entity1 with Glasgow @entity772 Scale (GCS) scores of 8 or less. The following data were collected: age, GCS score, presence of mass lesions, oculovestibular reflexes (OVR), pupillary size and reactivity, @entity428 ( @entity428 ), @entity386 , presence of @entity551 , @entity519 ( @entity4095 less than 60 torr), or hypercarbia (PCO2 greater than or equal to 35 torr), presence of @entity1230 , and Modified Injury Severity Scale (MISS) score. Outcome was assessed by the Glasgow Outcome Scale at a minimum of six months following recovery. Of the 200 @entity1 in the study, 86 (43%) had isolated @entity542 (IHI) and 114 (57%) had @entity542 plus @entity1230 (HI + MT). Overall, 26% of @entity1 had mass lesions; 28% had altered OVR; 33% had fixed, dilated pupils; 79% had @entity428 ; and 29% had @entity551 , @entity519 , or hypercarbia. Overall mortality was 21.5%. Severity of injury (as judged by presence of mass lesions, GCS, OVR, fixed pupils) was more pronounced in @entity1 with IHI, although @entity428 was more common in @entity1 with HI + MT; however, @entity204 was almost three times more common in @entity1 with HI + MT (30% versus 10.5%). In the IHI group, two of nine @entity1 who died (22%) had @entity551 , @entity519 , or hypercarbia; all but four @entity1 (88%) in the HI + MT group had @entity551 , @entity519 , or hypercarbia.(ABSTRACT TRUNCATED AT 250 WORDS)

XXXX : the critical role of the emergency physician.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity428 :: ('MESH:D019586', 'Disease') :: ['ICP', 'increased intracranial pressure', 'intracranial pressure', 'increased ICP'] @entity16 :: ('MESH:D009422', 'Disease') :: ['Neurologic injury'] @entity542 :: ('MESH:D006259', 'Disease') :: ['head injury'] @entity772 :: ('MESH:D003128', 'Disease') :: ['Coma'] @entity519 :: ('MESH:D000860', 'Disease') :: ['hypoxia'] @entity1230 :: ('MESH:D009104', 'Disease') :: ['multiple trauma'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity4095 :: ('MESH:C093415', 'Chemical') :: ['PO2'] @entity386 :: ('MESH:D001049', 'Disease') :: ['apnea']
@entity542 :: (MESH:D006259,Disease) :: ['Pediatric head injury']
