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. 2011 Nov;32(10):1806–1811. doi: 10.3174/ajnr.A2606

Mechanism of trauma, diagnostic modality, clinical signs and symptoms on admission, associated injuries, treatment, and outcome in 10 children with traumatic REH

No. Sex/Age Mechanism of Injury Diagnostic Modality Clinical Signs/Symptoms on Admission Associated Injuries Treatment Outcome
1 M/4 yr MVA CT/MR GCS score, 6; left sixth cranial nerve palsy Multiple skull fractures; intraparenchymal and subdural hematoma; shear injuries; left internal carotid artery dissection; transverse ligament injury Conservative (Miami J collar) Neurologic impairment related to DAI
2 F/15 yr Cattle roping CT/MR GCS score, 7 Intracranial hematoma; cerebral contusions; extra-axial hemorrhage; shear injuries Conservative (Miami J collar) Neurologic impairment related to DAI
3 M/6 yr Fall CT GCS score, 15; unremarkable Stretched tectorial membrane; apical ligament injury; mild compression of the brain stem Conservative Full recovery
4 F/9 yr MVA CT/MR GCS score, 6; left fourth, sixth, tenth, twelfth cranial nerve palsy; paresis of the left arm; bilateral upgoing toes Tectorial membrane disruption; left occipital condylar fracture with subluxation of C-spine; moderate compression of the brain stem; intraparenchymal hematoma; cerebral contusion, extra-axial hemorrhage Surgical fixation C0-C2 Neurologic impairment related to DAI
5 F/6 yr MVA CT/MR GCS score, 13; nausea, headache; bilateral sixth, ninth, twelfth cranial nerve palsy Tectorial membrane disruption Conservative (Miami J collar) Full recovery
6 F/21 mo Fall CT/MR GCS score, 14; nausea, headache Tectorial membrane disruption; skull fracture; extra-axial hemorrhage; apical ligament injury Conservative (Miami J collar) Full recovery
7 M/13 yr Go-cart accident CT GCS score, 15; mild nausea Stretched tectorial membrane; left occipital condylar fracture Conservative (Miami J collar) Full recovery
8 F/6 yr MVA CT/MR GCS score, 15; cervical pain Tectorial membrane disruption; mild compression of the brain stem Conservative (Miami J collar and thoracic lumbar sacral orthosis brace) Full recovery
9 F/9 yr MVA CT/MR GCS score, 5 Stretched tectorial membrane Conservative (Miami J collar) Full recovery
10 M/2 yr Car versus pedestrian CT/MR GCS score, 13; left femur fracture Apical and posterior atlanto-occipital membrane injury; skull fracture Conservative (Miami J collar) Full recovery