The Risk Factors for Massive Cerebral Infarction Secondary to Epidural Hematoma Caused by Brain Trauma in Children

Abstract

Massive cerebral infarction (MCI), which is associated with adverse outcomes and significant mortality rates, is one of the most severe complications following epidural hematoma (EDH) caused by brain trauma. In pediatric patients, the incidence of MCI is higher than in adults, yet current research on this condition remains limited. We conducted a multi-center retrospective study, collecting 15 clinical indicators from a cohort of 62 pediatric EDH patients who developed MCI and 65 pediatric EDH patients without MCI. The univariate and multivariate logistic analysis were performed for the preliminary evaluation of post-operative MCI to obtain the influencing factors of MCI. Of various parameters, 8 potential risk factors of cerebral infarction were revealed through the univariate analysis with statistically significant differences. And multivariate analysis of these indicators showed that 7 factors, including age, mid-line shift, preoperative Glasgow Coma Scale scores, traumatic subarachnoid hemorrhage, multiple injuries, mydriasis and perioperative shock turned out to be the main significant risk factors. Our results provide predictors for children cerebral infarction, making early recognition for risks and aggressive managements more possible to prevent MCI.