{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:03:01Z","timestamp":1787025781686,"version":"build-2736575974"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Considering Glasgow Coma Scale (GCS) scores and brain CT scans in a group of children and adolescents with traumatic brain injury (TBI), the scope of this study was to identify the criteria established for the indication of emergency neurosurgical treatment in a level 1 trauma center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This was a cross-sectional study with consecutive review of medical records of children and adolescents &lt; 17 years with TBI who were hospitalized and underwent neurosurgical treatment between January 2016 and December 2023. Two groups were formed for analysis: patients with GCS scores \u2264 8 versus patients with GCS scores &gt; 8. Based on the GCS score and brain CT scan of each patient, the authors investigated the criteria established for the surgical indications in this group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In the period considered for the study, 376 children and adolescents with TBI were hospitalized and 31% required neurosurgical treatment. The median age was 5 years (interquartile range 1\u201311 years) and there was a predominance of males (68%). Home accidents predominated in 77% of children &lt; 5 years of age, whereas road accidents predominated among those older than 5 (47%). Diffuse brain lesions on CT scans predominated in patients with GCS scores \u2264 8 when compared to the group with GCS scores &gt; 8 (89% vs 19%; p &lt; 0.0001). Regarding neurosurgical access, decompressive craniectomies (70%) and invasive intracranial pressure monitoring (44%) prevailed among patients with GCS scores \u2264 8, whereas craniotomies for drainage of intracranial hematomas (70%) and surgical correction of depressed skull fracture (21%) prevailed among those with GCS scores &gt; 8.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Based on the GCS scores and CT scans, the authors were able to define the criteria used for neurosurgical indications in a Brazilian level 1 trauma center. They found a high prevalence of decompressive craniectomy in patients with severe TBI in their department due to the irregular supply of disposable catheters necessary for intracranial pressure monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.8.peds24326","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T22:28:09Z","timestamp":1729290489000},"page":"72-78","source":"Crossref","is-referenced-by-count":3,"title":["Criteria for neurosurgical treatment of children and adolescents with traumatic brain injury in a Brazilian level 1 trauma center"],"prefix":"10.3171","volume":"35","author":[{"given":"Jos\u00e9 Roberto","family":"Tude Melo","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Santa Casa of S\u00e3o Paulo School of Medical Sciences; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Zampirolli","family":"Leal","sequence":"additional","affiliation":[{"name":"Santa Casa of S\u00e3o Paulo School of Medical Sciences, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larah Domingos","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Santa Casa of S\u00e3o Paulo School of Medical Sciences, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melina Houlis Hao","family":"Masini","sequence":"additional","affiliation":[{"name":"Santa Casa of S\u00e3o Paulo School of Medical Sciences, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Gon\u00e7alves","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Santa Casa of S\u00e3o Paulo School of Medical Sciences; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Carlos Esteves","family":"Veiga","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Santa Casa of S\u00e3o Paulo School of Medical Sciences; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"Childs Nerv Syst","first-page":"1077","article-title":"Defenestration in children younger than 6 years old: mortality predictors in severe head trauma","volume":"25","author":"Melo JRT","year":"2009","unstructured":"Melo JRT, Di Rocco F, Lemos-J\u00fanior LP,  Defenestration in children younger than 6 years old: mortality predictors in severe head trauma. Childs Nerv Syst. 2009;25(9):1077\u20131083."},{"issue":"11","key":"b2","series-title":"Childs Nerv Syst","first-page":"3071","article-title":"An update on pediatric traumatic brain injury","volume":"39","author":"Figaji A","year":"2023","unstructured":"Figaji A. An update on pediatric traumatic brain injury. Childs Nerv Syst. 2023;39(11):3071\u20133081."},{"issue":"6","key":"b3","series-title":"Childs Nerv Syst","first-page":"1119","article-title":"Traumatic brain injury in Indian children","volume":"34","author":"Chaitanya K","year":"2018","unstructured":"Chaitanya K, Addanki A, Karambelkar R, Ranjan R. Traumatic brain injury in Indian children. Childs Nerv Syst. 2018;34(6):1119\u20131123."},{"issue":"4","key":"b4","series-title":"J Neurosurg Pediatr","first-page":"361","article-title":"Primary prevention of road traffic accident-related traumatic brain injuries in younger populations: a systematic review of helmet legislation","volume":"25","author":"Du RY","year":"2020","unstructured":"Du RY, LoPresti MA, Garc\u00eda RM, Lam S. Primary prevention of road traffic accident-related traumatic brain injuries in younger populations: a systematic review of helmet legislation. J Neurosurg Pediatr. 2020;25(4):361\u2013374."},{"issue":"3","key":"b5","series-title":"J Neurosurg Pediatr","first-page":"335","article-title":"Socioeconomic health disparities in pediatric traumatic brain injury on a national level","volume":"29","author":"Kelly KA","year":"2021","unstructured":"Kelly KA, Patel PD, Salwi S, Iii HNL, Naftel R. Socioeconomic health disparities in pediatric traumatic brain injury on a national level. J Neurosurg Pediatr. 2021;29(3):335\u2013341."},{"issue":"4","key":"b6","series-title":"Article in Portuguese. Arq Neuropsiquiatr","first-page":"994","article-title":"Traumatic brain injury in children and adolescents at Salvador City, Bahia, Brazil","volume":"64","author":"Melo JRT","year":"2006","unstructured":"Melo JRT, de Santana DLP, Pereira JLB, Ribeiro TF. Traumatic brain injury in children and adolescents at Salvador City, Bahia, Brazil. Article in Portuguese. Arq Neuropsiquiatr. 2006;64(4):994\u2013996."},{"issue":"12","key":"b7","series-title":"N Engl J Med","first-page":"1119","article-title":"Trial of decompressive craniectomy for traumatic intracranial hypertension","volume":"375","author":"Hutchinson PJ","year":"2016","unstructured":"Hutchinson PJ, Kolias AG, Timofeev IS,  Trial of decompressive craniectomy for traumatic intracranial hypertension. N Engl J Med. 2016;375(12):1119\u20131130."},{"issue":"1","key":"b8","series-title":"BMC Emerg Med","first-page":"1","article-title":"Incidence of emergency neurosurgical TBI procedures: a population-based study","volume":"22","author":"Tverdal C","year":"2022","unstructured":"Tverdal C, Aarhus M, R\u00f8nning P,  Incidence of emergency neurosurgical TBI procedures: a population-based study. BMC Emerg Med. 2022;22(1):1."},{"issue":"5","key":"b9","series-title":"J Neurol Neurosurg Psychiatry","first-page":"567","article-title":"Early predictors of unfavourable outcome in subjects with moderate head injury in the emergency department","volume":"79","author":"Fabbri A","year":"2008","unstructured":"Fabbri A, Servadei F, Marchesini G, Stein SC, Vandelli A. Early predictors of unfavourable outcome in subjects with moderate head injury in the emergency department. J Neurol Neurosurg Psychiatry. 2008;79(5):567\u2013573."},{"issue":"6","key":"b10","series-title":"Neurosurgery","first-page":"1542","article-title":"Mortality in children with severe head trauma: predictive factors and proposal for a new predictive scale","volume":"67","author":"Melo JRT","year":"2010","unstructured":"Melo JRT, Di Rocco F, Blanot S,  Mortality in children with severe head trauma: predictive factors and proposal for a new predictive scale. Neurosurgery. 2010;67(6):1542\u20131547."},{"key":"b11","article-title":"Secretaria de Estado da Sa\u00fade. S\u00e3o Paulo Governo do Estado","unstructured":"Secretaria de Estado da Sa\u00fade. S\u00e3o Paulo Governo do Estado. 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Childs Nerv Syst. 1998;14(9):455\u2013459."},{"key":"b16","article-title":"Brazilian Institute of Geography and Statistics (IBGE). Cities and States demographic census","unstructured":"Brazilian Institute of Geography and Statistics (IBGE). Cities and States demographic census. Accessed September 9, 2024. http:\/\/www.ibge.gov.br"},{"issue":"4","key":"b17","series-title":"Braz Neurosurg","first-page":"133","article-title":"First Brasilian cooperative study on neurotraumatology. Preliminary reports","volume":"24","author":"Andrade AF","year":"2005","unstructured":"Andrade AF, Maset AL, Val\u00eancio CR,  First Brasilian cooperative study on neurotraumatology. Preliminary reports. 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