PEDIATRICS Vol. 71 No. 5 May 1983, pp. 756-762
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Long-Term Outcome of Children with Severe Head Trauma and Prolonged Coma

William J. Mahoney MD1, Bernard J. D'Souza MD1, J. Alex Haller MD1, Mark C. Rogers MD1, Melvin H. Epstein MD1, and John M. Freeman MD1

1 From the Departments of Neurology and Pediatrics, Divisions of Pediatric Neurology and Pediatric Surgery, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore

Forty-six children with significant head trauma who remained in coma more than 24 hours were the subjects of this long-term outcome study. Twelve (38%) died. The average length of coma in the 34 survivors was 15.5 days. Follow-up ranged from 9 months to 4 years (mean 21 months). Twenty-nine percent of the survivors were normal at follow-up. An additional 53% had mild cognitive or behavioral problems, but 61% of these had evidence of similar problems prior to the injury. Nine percent of survivors had motor residua but normal intellect. Nine percent had severe intellectual and motor problems. Children less than 2 years of age had a worse outcome. Despite severe injury and prolonged coma after head trauma, most children do well. Intensive medical and surgical care increases the rate of survival and does not result in a large number of severely disabled survivors.

Key Words: coma • head trauma • motor and intellectual impairment

Submitted on April 5, 1982
Accepted on October 29, 1982




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