Cranial puncture and drainage under CT guidance for acute traumatic intracranial hematomas in children

WEI Ke; DU Wei; CHEN Da-yu; YANG Liu; YAO Guo-jie

doi:10.13798/j.issn.1009-153X.2023.10.011

Abstract：Objective To explore the clinical efficacy of CT-guided cranial puncture and drainage for pediatric acute traumatic intracranial hematomas.Methods The clinical data of 42 children with acute traumatic intracranial hematomas treated from May 2016 to October 2021 were retrospectively analyzed.Results Twenty-six patients had epidural hematomas with a mean hematoma volume of(25.5±5.53)ml.Twelve patients had cerebral contusion and laceration complicated with intracerebral hematoma with a mean hematoma volume of(20.25±2.2)ml.Four patients had hematoma in basal ganglia with a mean hematoma volume of(20.75±2.38)ml.Cranial puncture and drainage under CT guidance was performed in all 42 children for 2～5 days with a drainage volume of 20～60 ml.All 42 patients were discharged from hospital without intracranial infection,delayed hemorrhage,seizure and other complications.On discharge,6 patients had limb palsy,which was returned to normal after rehabilitation treatment for half a year,and the other 36 patients had satisfactory curative effect,normal cognition and understanding,good recovery of limb function,and good self-care ability.Conclusions Children have poor tolerance to craniotomy for traumatic brain injury,which is easy to cause hemorrhagic shock and internal environment disorder,and the risk of craniotomy is higher than that of adults.For children with acute traumatic brain injury accompanied by hematoma,Cranial puncture and drainage assisted with CT positioning is less traumatic,faster recovery,and can reduce the risk and pain of children,and can obtain excellent curative effect.