Packing to Tamponade Severe Intracranial Hemorrhage in Pediatric Patients

Abstract

The medical records of all children in whom packing was used to control severe intracranial hemorrhage were reviewed. Eight children, with ages ranging from newborn to 4 years, met the inclusion criteria and all survived. Five were victims of severe closed head trauma, 2 had received penetrating cranial injuries, and 1 developed severe bleeding while undergoing surgery for a malignant tumor in the posterior fossa. Blood loss at the time of removal of the packing was minimal in 7 patients and was surgically controllable in the other. Packing is a simple, efficient, and safe maneuver which can very often halt intracranial bleeding that is considered to be otherwise uncontrollable, and can thereby limit the consequences of prolonged or repeated periods of hypotension and possible exsanguination.

Endovascular Treatment Following Gauze Packing for the Control of Massive Bleeding from Traumatic Transverse Sinus Lesion

“…The classical EDH occurs beneath a temporo-parietal skull fracture as a result of damage to the middle meningeal artery. 18) However, occasional non-arterial bleeding, including bleeding from venous dural sinuses, emissary veins, or venous lake within the dura matter, or even a rupture of arachnoid granulation, can be the primary source of the hematoma. 9 20) Surgeons should be aware of the possibility of sinus bleeding when they encounter EDHs within the anatomical locations adjacent to major venous sinuses including vertex, 12 16) and posterior fossae.…”