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Central Autonomic Dysfunction Following Acquired Brain Injury in Children

Department of Rehabilitation, Gillette Children's Specialty Healthcare

Robert L. Kriel

Department of Pediatrics and Neurology at Gillette Children's Specialty Healthcare, Hennepin County Medical Center and the University of Minnesota

William F. Morris

Department of Physical Medicine and Rehabilitation, University of Minnesota

Bonnie L. Warhol

Department of Physical Medicine and Rehabilitation, University of Minnesota

Michael G. Luxenberg

Professional Data Analysts, St. Paul/Minneapolis, Minnesota

This study describes the characteristics of children who had central autonomic dys function (CAD) after acquired brain injury. CAD was defined as an unexplained increase in body temperature, blood pressure, or respiratory rate. We surveyed a con secutive series of 220 children who had been unconscious for 24 or more hours after acquired brain injury. Thirty-one children met criteria for CAD by chart review. The development of CAD carried with it serious implications as those children were uncon scious longer (median 150 vs. 28 days), had worse cognitive and motor outcomes, and were more likely to die (16 vs. 3.6%). Follow-up neuroimaging studies most com monly showed moderate to severe atrophy and ventricular enlargement. The onset of CAD was usually seen within one month of injury and frequently within one week. All patients required medication to control the symptoms of CAD; nine still required intervention six or more months after injury. CAD is commonly seen in children with severe brain injury. It complicates the management of these patients, reflects more severe injury, is usually associated with less favorable outcome, and can seriously inter fere with rehabilitation programs. Key Words: Central autonomic dysfunction— Dysautonomia—Central fever—Acquired pediatric brain injury.

Neurorehabilitation and Neural Repair, Vol. 11, No. 1, 41-45 (1997)
DOI: 10.1177/154596839701100107


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