Pediatric Neurotrauma

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Abstract

Traumatic brain injury (TBI) is the leading cause of death and disability in children over 1 year of age. Knowledge about the age-specific types of injury and how to manage children with neurotrauma is essential to understanding and recognizing the extent and degree of injury and to optimize outcomes. In this article, we review the epidemiology, pathophysiology, and clinical management of pediatric neurotrauma.

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Most cited references 32

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Epidemiology and outcomes of pediatric traumatic brain injury.

Donna L. Bratton, Brendan T Keenan, Susan Bratton (2006)

Traumatic brain injury is a leading cause of death and disability in the pediatric age group. Causes of injury vary with child developmental age, with more inflicted injuries in infants, fall-related injuries among toddlers, sports-related injuries among middle-school-aged children and motor vehicle crashes in older children. Prevention strategies exist for some pediatric traumatic brain injury; however, all suffer from lack of compliance and enforcement. Neuropsychological and behavioral outcomes for injured children vary with the severity of injury, child age at injury, premorbid child characteristics, family factors and the families' socioeconomic status. Each of these factors needs to be taken into account when designing rehabilitation strategies and assessing factors related to outcome. Copyright (c) 2006 S. Karger AG, Basel.

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Annual summary of vital statistics: 2007.

Melonie Heron, Paul D. Sutton, Jiaquan Xu … (2010)

The number of births in the United States increased between 2006 and 2007 (preliminary estimate of 4,317,119) and is the highest ever recorded. Birth rates increased among all age groups (15 to 44 years); the increase among teenagers is contrary to a long-term pattern of decline during 1991-2005. The total fertility rate increased 1% in 2007 to 2122.5 births per 1000 women. This rate was above replacement level for the second consecutive year. The proportion of all births to unmarried women increased to 39.7% in 2007, up from 38.5% in 2006, with increases noted for all race and Hispanic-origin groups and within each age group of 15 years and older. In 2007, 31.8% of all births occurred by cesarean delivery, up 2% from 2006. Increases in cesarean delivery were noted for most age groups and for non-Hispanic white, non-Hispanic black, and Hispanic women. Multiple-birth rates, which rose rapidly over the last several decades, did not increase during 2005-2006. The 2007 preterm birth rate was 12.7%, a decline of 1% from 2006. The low-birth-weight rate also declined in 2007 to 8.2%. The infant mortality rate was 6.77 infant deaths per 1000 live births in 2007, which is not significantly different from the 2006 rate. Non-Hispanic black infants continued to have much higher rates than non-Hispanic white and Hispanic infants. States in the southeastern United States had the highest infant and fetal mortality rates. The United States continues to rank poorly in international comparisons of infant mortality. Life expectancy at birth reached a record high of 77.9 years in 2007. Crude death rates for children aged 1 to 19 years decreased by 2.5% between 2006 and 2007. Unintentional injuries and homicide were the first and second leading causes of death, respectively, accounting for 53.7% of all deaths to children and adolescents in 2007.

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Pediatric traumatic brain injury: not just little adults.

Richard Mink, Christopher C Giza, Andranik Madikians (2007)

This review will update the reader on the most significant recent findings with regards to both the clinical research and basic science of pediatric traumatic brain injury. The developing brain is not simply a smaller version of the mature brain. Studies have uncovered important distinctions of the younger brain after traumatic brain injury, including an increased propensity for apoptosis, age-dependent parameters for cerebral blood flow and metabolism, development-specific biomarkers, increased likelihood of early posttraumatic seizures, differential sensitivity to commonly used neuroactive medications and altered neuroplasticity during recovery from injury. Specifically, there is strong preclinical evidence for increased neuronal apoptosis in the developing brain being triggered by anesthetics and anticonvulsants, making it paramount that future studies more clearly delineate preferred agents and specific indications for use, incorporating long-term functional outcomes as well as short-term benefits. In addition, the young brain may actually benefit from therapeutic interventions that have been less effective following adult traumatic brain injury, such as decompressive craniectomy and hypothermia. An increasing body of evidence demonstrates the importance of establishing age-dependent guidelines for physiological monitoring, pharmacological intervention, management of intracranial pressure and facilitating recovery of function.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Crit Illn Inj Sci

Journal ID (iso-abbrev): Int J Crit Illn Inj Sci

Journal ID (publisher-id): IJCIIS

Title: International Journal of Critical Illness and Injury Science

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 2229-5151

ISSN (Electronic): 2231-5004

Publication date (Print): Apr-Jun 2014

Volume: 4

Issue: 2

Pages: 131-137

Affiliations

[1 ]Department of Anesthesiology, University of Washington, USA

[2 ]Department of Pediatrics, University of Washington, USA

[3 ]Department of Neurological Surgery, University of Washington, USA

[4 ]Harborview Injury Prevention and Research Center, Seattle, WA, USA

Author notes

Address for correspondence: Prof. Monica S. Vavilala, Department of Anesthesiology, Pediatrics and Neurological Surgery (Adj.), Harborview Medical Center, Box 359724, 325 Ninth Avenue, Seattle, WA 98104, USA. E-mail: vavilala@ 123456u.washington.edu

Article

Publisher ID: IJCIIS-4-131

DOI: 10.4103/2229-5151.134152

PMC ID: 4093963

SO-VID: 631acec4-cd57-4476-8edd-4fea13b5fc32

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Pediatric Neurotrauma

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Pediatric Pulse: Advancing Neonatal and Child Health

Most cited references 32

Epidemiology and outcomes of pediatric traumatic brain injury.

Annual summary of vital statistics: 2007.

Pediatric traumatic brain injury: not just little adults.

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