The case report presents the case of a five-year-old boy who fell off a scooter and sustained a blow to the left temporal region of his head. During a CT examination in the district hospital he suddenly showed a deterioration in the level of consciousness. Subsequent treatment along with transport to a specialized department were aimed at preventing secondary pathological changes and maintaining pressure-volume homeostasis of the brain. High-quality controlled ventilation with effective pharmacotherapy and gentle transport were essential. At the target specialized department, cerebral oedema in the left temporal region and aspiration in the right upper lung lobe were identified. The boy was extubated after 6 hours of controlled ventilation and discharged to an intermediate care bed two days later without any serious consequences. Key words: cerebral oedema, haemodynamic swelling, severe head injury.

Klinika anesteziologie a resuscitace 3 lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady Praha

Klinika anesteziologie resuscitace a intenzivní medicíny 2 lékařské fakulty Univerzity Karlovy a Fakultní nemocnice v Motole Praha

Vysoká škola zdravotnická Praha

Zdravotnická záchranná služba Středočeského kraje Kladno

Severe Head Injury in Childhood: the Importance of Early Offensive Therapy