TITLE:
Analysis of Prognostic Factors of Children with Intracranial Infection Coma
AUTHORS:
Yan Peng, Li Jiang
KEYWORDS:
Coma, Clinical, Outcome, Intracranial, Infection
JOURNAL NAME:
World Journal of Neuroscience,
Vol.5 No.2,
May
26,
2015
ABSTRACT: Objective: To investigate
the prognostic factors of coma due to intracranial infection in children, in
order to judge the prognosis of coma earlier and guide appropriate treatment.
Methods: 1) Collecting the clinical data of 39 comatose children due to
intracranial infection admitted into Department of Neurology in Children’s
Hospital of Chongqing Medical University from July to September 2007 and 2009,
and analyzing their age and sex distribution, causes of coma, and laboratory
examinations retrospectively. 2) Implementing the Glasgow coma score among
these children immediately after admission, and collecting the serum and
cerebrospinal fluid within 24 - 48 hours, and then measuring the NSE levels. 3)
Following up these children 3 months after discharge, and analyzing the
relationships among prognosis and age, sex, etiology, protein content in CSF,
and NSE levels in Serum and CSF. Results: 1) In the cases studied, the age
range was from 9 months to 14 years, the average age was (4.25 ± 2.82) years,
and 9 months - 3 years, 3 - 5 years, 5 - 11 years, and ≥11 years were accounted
for 33.3%, 30.8%, 30.8%, 5.1% respectively. There were 24 males and 15 females,
and the gender ratio (male-to-female) was 1.6:1. 2) The group of 39 patients
consists of Japanese encephalitis (23 cases, 59%), Viral encephalitis (5 cases,
12.8%), Tuberculous meningitis (5 cases, 12.8%), Acute disseminated
encephalomyelitis (5 cases, 12.8%) and Purulent meningitis (1 cases, 2.6%). 3)
CSF examination in 33 cases, protein elevated in 18 cases (54.5%), content
between 0.47 and 4.33 g/L. 4) The statistical analysis showed that the causes,
CSF protein content, serum and cerebrospinal fluid NSE levels were correlated
with the prognosis, and that the age and sex had no correlation with the
prognosis. Conclusions: 1) In this group of 39 patients, the incidence of
children under 5 years old was the highest, and the incidence of boys was
higher than girls. 2) Infectious diseases were the most common cause of coma in
children. 3) Cerebrospinal fluid protein content was correlated with the
prognosis, and the prognosis was worse as the protein content was higher. 4)
NSE was a specific biochemical parameter of pathological damagenerve tissue; serum NSE levels could
indirectly reflect the changes in CSF.