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

No.Sex/AgeMechanism of InjuryDiagnostic ModalityClinical Signs/Symptoms on AdmissionAssociated InjuriesTreatmentOutcome
1M/4 yrMVACT/MRGCS score, 6; left sixth cranial nerve palsyMultiple skull fractures; intraparenchymal and subdural hematoma; shear injuries; left internal carotid artery dissection; transverse ligament injuryConservative (Miami J collar)Neurologic impairment related to DAI
2F/15 yrCattle ropingCT/MRGCS score, 7Intracranial hematoma; cerebral contusions; extra-axial hemorrhage; shear injuriesConservative (Miami J collar)Neurologic impairment related to DAI
3M/6 yrFallCTGCS score, 15; unremarkableStretched tectorial membrane; apical ligament injury; mild compression of the brain stemConservativeFull recovery
4F/9 yrMVACT/MRGCS score, 6; left fourth, sixth, tenth, twelfth cranial nerve palsy; paresis of the left arm; bilateral upgoing toesTectorial membrane disruption; left occipital condylar fracture with subluxation of C-spine; moderate compression of the brain stem; intraparenchymal hematoma; cerebral contusion, extra-axial hemorrhageSurgical fixation C0-C2Neurologic impairment related to DAI
5F/6 yrMVACT/MRGCS score, 13; nausea, headache; bilateral sixth, ninth, twelfth cranial nerve palsyTectorial membrane disruptionConservative (Miami J collar)Full recovery
6F/21 moFallCT/MRGCS score, 14; nausea, headacheTectorial membrane disruption; skull fracture; extra-axial hemorrhage; apical ligament injuryConservative (Miami J collar)Full recovery
7M/13 yrGo-cart accidentCTGCS score, 15; mild nauseaStretched tectorial membrane; left occipital condylar fractureConservative (Miami J collar)Full recovery
8F/6 yrMVACT/MRGCS score, 15; cervical painTectorial membrane disruption; mild compression of the brain stemConservative (Miami J collar and thoracic lumbar sacral orthosis brace)Full recovery
9F/9 yrMVACT/MRGCS score, 5Stretched tectorial membraneConservative (Miami J collar)Full recovery
10M/2 yrCar versus pedestrianCT/MRGCS score, 13; left femur fractureApical and posterior atlanto-occipital membrane injury; skull fractureConservative (Miami J collar)Full recovery