Pediatric Annals

Feature Article 

A 3-year-old Boy Involved in a Motor Vehicle Accident

Abstract

EXCERPT

A 3-year-old boy who was involved in a motor vehicle accident two months prior to admission was transferred for evaluation. He, his 6-year-old sibling, and his father were properly restrained passengers in a car driven by the boy’s pregnant mother, when they were hit by another car traveling at an estimated 85 mph. This boy was the only survivor of that accident. He was pulled from the car by emergency medical technicians, received cardiopulmonary resuscitation at the scene, and was taken to a community hospital. In route, he had a generalized seizure and received intravenous fosphenytoin. At the hospital, he was unresponsive and had labored breathing.

Key Learning Points

  1. Individuals in a persistent vegetative state (PVS) have lost cognitive neurologic function and awareness of the environment but retain noncognitive function and maintain a normal sleep-wake cycle. The term PVS only applies after a period of observation, for usually at least six months.
  2. Neurologic prognostication following closed-head injury during the first several months following the traumatic event cannot be performed with any degree of accuracy.

ABOUT THE AUTHOR

Robert Listernick, MD, is Professor of Pediatrics at Feinberg School of Medicine, Northwestern University, and Director of the Diagnostic and Consultation Service, Division of General Academic Pediatrics, Children’s Memorial Hospital, Chicago, IL.

Abstract

EXCERPT

A 3-year-old boy who was involved in a motor vehicle accident two months prior to admission was transferred for evaluation. He, his 6-year-old sibling, and his father were properly restrained passengers in a car driven by the boy’s pregnant mother, when they were hit by another car traveling at an estimated 85 mph. This boy was the only survivor of that accident. He was pulled from the car by emergency medical technicians, received cardiopulmonary resuscitation at the scene, and was taken to a community hospital. In route, he had a generalized seizure and received intravenous fosphenytoin. At the hospital, he was unresponsive and had labored breathing.

Key Learning Points

  1. Individuals in a persistent vegetative state (PVS) have lost cognitive neurologic function and awareness of the environment but retain noncognitive function and maintain a normal sleep-wake cycle. The term PVS only applies after a period of observation, for usually at least six months.
  2. Neurologic prognostication following closed-head injury during the first several months following the traumatic event cannot be performed with any degree of accuracy.

ABOUT THE AUTHOR

Robert Listernick, MD, is Professor of Pediatrics at Feinberg School of Medicine, Northwestern University, and Director of the Diagnostic and Consultation Service, Division of General Academic Pediatrics, Children’s Memorial Hospital, Chicago, IL.

10.3928/0090-4481-20061201-07

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