POSTTRAUMATIC BILATERAL DIFFUSE CEREBRAL SWELLING

This study confirms that bilateral diffuse cerebral swelling with or w ithout parenchymal haemorrhages (< 15 cc) is a more common occurrence in the paediatric patients with severe head injury as compared with ad ults, since the analysed sample represented 42.55% and 20.43% of all p aediatric and adult patients with severe head injury recorded in our c linic at the time of the study, respectively. The incidence of patient s with diffuse cerebral swelling without parenchymal haemorrhages was found to be 27.65% of paediatric patients and 5.37% of adult patients with severe head injury. Secondary neurological deterioration occurred only in 5 (12.5%) paediatric patients and in 4 (10.5%) adult patients with diffuse cerebral swelling and was not to be found associated wit h parenchymal haemorrhages. A better outcome was seen in paediatric pa tients. Mortality rates were 12.5% in paediatric patients and 34.21% i n adult patients. Our data also suggest that the mortality rate betwee n paediatric and adult patients with diffuse cerebral swelling without parenchymal haemorrhages was similar (15.38% and 20% in paediatric an d adult group, respectively), while the adult patients with diffuse ce rebral swelling associated with small intraparenchymal haemorrhages ha ve a worse prognosis than paediatric patients.