Pediatric Traumatic Brain Injury: Characteristic Features, Diagnosis, and Management

Araki, Takashi; Yokota, Hiroyuki; Morita, Akio

doi:10.2176/nmc.ra.2016-0191

Cited by 226 publications

(176 citation statements)

References 73 publications

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“…Traumatic brain injury (TBI) sustained early in life has long‐term consequences for development and ranks among the most common causes of death and disability in children and adolescents (Araki, Yokota, & Morita, ). Pediatric TBI represents a particular risk for long‐term impairments and interruption of normal development given the vulnerability of the developing brain to structural and functional disruption (Anderson, Spencer‐Smith, & Wood, ; Crowe, Catroppa, Babl, & Anderson, ).…”

Section: Introductionmentioning

confidence: 99%

Altered resting‐state functional connectivity within the developing social brain after pediatric traumatic brain injury

Tuerk

Dégeilh

Catroppa

et al. 2019

Human Brain Mapping

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Traumatic brain injury (TBI) in childhood and adolescence can interrupt expected development, compromise the integrity of the social brain network (SBN) and impact social skills. Yet, no study has investigated functional alterations of the SBN following pediatric TBI. This study explored functional connectivity within the SBN following TBI in two independent adolescent samples. First, 14 adolescents with mild complex, moderate or severe TBI and 16 typically developing controls (TDC) underwent resting-state functional magnetic resonance imaging 12-24 months post-injury.Region of interest analyses were conducted to compare the groups' functional connectivity using selected SBN seeds. Then, replicative analysis was performed in an independent sample of adolescents with similar characteristics (9 TBI, 9 TDC). Results were adjusted for age, sex, socioeconomic status and total gray matter volume, and corrected for multiple comparisons. Significant between-group differences were detected for functional connectivity in the dorsomedial prefrontal cortex and left fusiform gyrus, and between the left fusiform gyrus and left superior frontal gyrus, indicating positive functional connectivity for the TBI group (negative for TDC). The replication study revealed group differences in the same direction between the left superior frontal gyrus and right fusiform gyrus. This study indicates that pediatric TBI may alter functional connectivity of the social brain. Frontal-fusiform connectivity has previously been shown to support affect recognition and changes in the function of this network could relate to more effortful processing and broad social impairments.

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Section: Introductionmentioning

confidence: 99%

Altered resting‐state functional connectivity within the developing social brain after pediatric traumatic brain injury

Tuerk

Dégeilh

Catroppa

et al. 2019

Human Brain Mapping

View full text Add to dashboard Cite

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“…Considering types of injuries, falling from height and motor vehicle accidents lead the way in children under 14 years of age. In children under the age of four, child abuse is also included in the clinical picture [3] . In our series, fall from height (56.3%) and motor vehicle accidents (34.4%) were the most frequent injury mechanisms observed in parallel with the literature.…”

Section: Discussionmentioning

confidence: 99%

“…In the United States, 475.000 children are exposed to head trauma each year, while 37.000 of them are hospitalized and 2.685 of them die [3] . Especially in children under four years of age, mortality and disability rates have been reported to be higher than other age groups with the addition of child abuse rates [4] .…”

mentioning

confidence: 99%

Evaluation of Common Experience of Neurosurgery and Pediatric Intensive Care Unit on Pediatric Head Trauma under the Light of Current Literature: Analysis of 96 Cases

Gürbüz¹

2019

Haydarpasa Numune Med J

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Introduction: This study aimed to evaluate the features and injury mechanisms of pediatric head trauma, demographics of the patients and factors affecting the outcome and to present the common experience of neurosurgery and pediatric intensive care unit (PICU) in light of the current literature. Methods: Ninety-six of 110 children under the age of 18 who had sufficient data and were treated in PICU for head trauma between 2014 and 2018 were evaluated retrospectively. The association between age, sex, mechanism of injury, neurological examination at presentation, Glasgow coma scale (GCS) score, history of cardiopulmonary resuscitation, shock, blood glucose level, hypoxia, convulsion, mean arterial pressure, heart rate per minute, body temperature, intracranial pressure (ICP) values, surgical interventions and Glasgow outcome scale (GOS) scores was investigated. Results: There were 32 patients (33.3%) in mild head trauma group, 28 patients (29.1%) in moderate head trauma group and 36 patients (37.5%) in severe head trauma group. Isolated head trauma was present in 49 patients, and multitrauma was observed in the remaining. The rate of favourable outcome was 72.9% (70 patients), and that of unfavourable outcome was 27.1% (26 patients) with the mortality rate of 15.6%. A moderate and negative correlation between presenting GCS scores and presenting blood glucose levels (rho: -0.422 p<0.001), and a moderate and positive correlation between presenting GCS scores and presenting body temperature were observed (rho: 0.422 p<0.001). A highly significant positive correlation was observed between GCS and 1-year GOS scores (rho: 0.762 p<0.001). Discussion and Conclusion: Analyzing the characteristics of pediatric head trauma, knowing the prognostic factors, developing a common algorithm and standardizing the management parallel to current literature will contribute to a favourable prognosis.

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“…Moreover, the neck muscles in the children are weak; thereby any trauma disturbs the cranio cervical stability, affecting the vertebrae. 5 In all cases of pediatric head trauma, the role of clinical examination should never be undermined. From specific primary injuries including scalp injury, concussion, contusion intraventricular hemorrhages and penetrating injuries, initial clinical examination of the general condition and specific local examination will help in formulating a differential diagnosis among the patients.…”

Section: Introductionmentioning

confidence: 99%

Validity of clinical examination in screening pediatric minor head trauma with loss of consciousness

Jayapal¹,

Mansour²

2018

Int J Contemp Pediatr

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Background: Minor head injury is the most common presentation in the emergency room for pediatric cases. Though most of them present with intact consciousness, there is an increased risk of primary and secondary brain damage, owing to several mechanical and cellular pathophysiological changes following trauma. Computed Tomography (CT) is the gold standard diagnostic tool for trauma; however, it has been reported that 30% of CT examinations are unwarranted. This study was carried out to evaluate the diagnostic validity of clinical examination in pediatric minor head trauma.Methods: This cross-sectional study was carried out among 355 patients between 1-15 years of age presenting to the ER, who had closed minor head trauma and loss of consciousness. Patients with GCS of 13-15 were included. A thorough clinical examination including head and neck was carried out. All the participants were subjected to CT examination. Data was entered and analyzed using Microsoft Excel spreadsheet.Results: The prevalence of minor head trauma detected by CT examination was 21.4%. The sensitivity and specificity of clinical examination were 71% and 63.8% respectively. The negative predictive value of the screening test was 89%.Conclusions: The value of clinical examination in detecting minor head trauma may be well complemented by the development of standardized clinical criteria which may be evaluated for its diagnostic capability. Following efficient clinical tool will minimize CT examinations and thereby prevent lethal complications due to radiation overdose in the pediatric population.

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Pediatric Traumatic Brain Injury: Characteristic Features, Diagnosis, and Management

Cited by 226 publications

References 73 publications

Altered resting‐state functional connectivity within the developing social brain after pediatric traumatic brain injury

Altered resting‐state functional connectivity within the developing social brain after pediatric traumatic brain injury

Evaluation of Common Experience of Neurosurgery and Pediatric Intensive Care Unit on Pediatric Head Trauma under the Light of Current Literature: Analysis of 96 Cases

Validity of clinical examination in screening pediatric minor head trauma with loss of consciousness

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