PEDIATRIC CASES OF NEUROSURGERY DIAGNOSED IN EMERGENCY ROOM

This retrospective study includes 400 children (70.3% boys and 29.7% girls) under 12 years of age, referred to the emergency room of Sina hospital in Tehran during the years 1993-1998. Clinical signs consisted of headache (81.7%), hematoma (64%), lethargy (47%), and vomiting (27.5%). A positive radiographic lesion was found in only 10% of the cases. The causes of trauma were: Head injury (82.5%), spinal column injury (7.5%), brain tumor (1.75%), high intracranial pressure (1.75%), and congenital anomalies of the central nervous system (Hydrocephaly, meningocele, etc) (3%). 80% of the patients came into emergency room in the first 48 hours after the accident. The most frequent neurologic sequelae consisted of post-traumatic syndrome, retrospective and prospective insomnia and seizures. The highest mortality rate was seen in the age group under 3 years and over 10 years. There was a significant relation between the indication for surgery and Glasgow coma staging.