Severe brain injuries in children

Ciurea, Alexandru Vlad; Coman, Teodora Camelia; Rosu, L; Ciurea, Jean; BĂiaşu, S.

doi:10.1007/3-211-27577-0_38

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…Diffuse brain injury in adult rats-induced by central fluid-percussion brain trauma-results in acute and chronic cognitive (learning) deficits in the absence of overt neuronal loss in any region of the brain, including the hippocampus (Lyeth et al, 1990); however, the inability of the injured hippocampus to initiate or maintain long-term potentiation has been suggested as one underlying mechanism for post-traumatic cognitive dysfunction (Miyazaki et al, 1992). Diffuse brain injury in infants and children results in extensive TAI in the subcortical white matter which was positively correlated with poor outcome (Ciurea et al, 2005;Grados et al, 2001;Tong et al, 2004), an observation supported in the present study by data demonstrating TAI and cognitive dysfunction in the youngest animals. The PND11 rat also exhibited extensive and persistent TAI in the thalamus in the chronic post-injury period, consistent with a recent report demonstrating that children with greater lesion volumes of TAI in the deeper structures of the brain such as the thalamus was associated with poor functional outcomes (Tong et al, 2004).…”

Section: Discussionmentioning

confidence: 98%

“…Deficits in cognitive and motor functions are more severe in children younger than 4 years of age compared to older children (Anderson et al, 2001;Levin et al, 1992;Verger et al, 2000). The pathologic hallmark of moderate-to-severe TBI in children is diffuse axonal injury, which is postulated to be an underlying cause of trauma-induced behavioral deficits (Chiaretti et al, 1998;Ciurea et al, 2005;Tong et al, 2004). Furthermore, closed head injury in infants often results in diffuse brain atrophy, a feature that is not commonly observed in older children (Duhaime et al, 1999).…”

Section: Introductionmentioning

confidence: 96%

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Diffuse Brain Injury in the Immature Rat: Evidence for an Age-at-Injury Effect on Cognitive Function and Histopathologic Damage

Raghupathi

Huh

2007

Journal of Neurotrauma

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Diffuse axonal injury is a significant component of the pathology of moderate-severe pediatric traumatic brain injury in children less than 4 years of age, and is associated with poor cognitive outcome. However, cognitive deficits or gross histopathologic abnormalities are typically not observed following moderate-severe diffuse brain injury in the immature (17-day-old) rat. In order to test whether the age of the immature animal may influence post-traumatic outcome, non-contusive brain trauma was induced in post-natal day (PND) 11 or 17 rats. Brain injury in the PND11 rat, but not in the PND17 rat, was associated with a significant acquisition deficit at 28 days post-injury (p<0.0005 compared with age-matched sham rats, and with brain-injured PND17 rats). All brain-injured animals exhibited a retention deficit in the probe trial (p<0.001), but also demonstrated a significant visual deficit in the visible platform trial (p<0.05 compared to sham animals). Although significantly longer times of apnea and loss of righting reflex were observed in brain-injured PND17 rats compared to PND11 rats (p<0.05), overt cytoarchitectural alterations and reactive gliosis were not observed in the older age group. No focal pathology was observed in the cortex below the impact site in the PND11 rat but by 28 days, the brain-injured PND11 rat exhibited atrophy in multiple brain regions and an enlarged lateral ventricle in the impact hemisphere. Quantitative analysis revealed a time-dependent increase in tissue loss in the injured hemisphere (7-10%) in the younger animals, and a modest extent of tissue loss in the older animals (3-4%). Traumatic axonal injury was observed to similar extents in the white matter and thalamus below the impact site in both brain-injured PND11 and 17 rats. These data demonstrate that non-contusive (diffuse) brain injury of moderate severity in the immature rat is associated with chronic cognitive deficits and long-term histopathologic alterations and suggest that the age-at-injury is an important parameter of behavioral and pathologic outcome following closed head injury in the immature age group.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 96%

Diffuse Brain Injury in the Immature Rat: Evidence for an Age-at-Injury Effect on Cognitive Function and Histopathologic Damage

Raghupathi

Huh

2007

Journal of Neurotrauma

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“…It is better to extend the CT scan to cervical spine and in road traffi c accidents to thoracic and abdominal area [2]. All these patients with severe HI are in comatose status and must be admitted to a PICU with special facilities for infants, toddlers and children.…”

Section: Severe Head Injurymentioning

confidence: 99%

“…A CT scan, native and bone window, is performed immediately, and according to the neuroimaging result the child is admitted into the pediatric intensive care unit (PICU) or is taken directly into the operating room, where specifi c treatment is initiated [2]. It is better to extend the CT scan to cervical spine and in road traffi c accidents to thoracic and abdominal area [2].…”

Section: Severe Head Injurymentioning

confidence: 99%

Cranial Traumas in Children

Ciurea¹

2009

Practical Handbook of Neurosurgery

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“…ICH is the most frequent cause of death and disability following severe TBI [46][47][48]. ICH (defined as ICP ?20 mmHg) is a known independent risk factor for poor neurological outcomes [49].…”

Section: Intracranial Hypertension (Ich)mentioning

confidence: 99%

Decompressive craniectomy in traumatic brain injury: Quo Vadis?

et al. 2014

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Intracranial hypertension is the leading cause of mortality in patients with cranial injury. Currently the traumatic brain injury is a public health problem worldwide. Decompressive craniectomy emerges as a treatment strategy for patients with refractory intracranial hypertension. The completed surgery requires careful surgical technique and exquisite. We present a review of the literature about the technique.

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Severe brain injuries in children

Cited by 8 publications

References 17 publications

Diffuse Brain Injury in the Immature Rat: Evidence for an Age-at-Injury Effect on Cognitive Function and Histopathologic Damage

Diffuse Brain Injury in the Immature Rat: Evidence for an Age-at-Injury Effect on Cognitive Function and Histopathologic Damage

Cranial Traumas in Children

Decompressive craniectomy in traumatic brain injury: Quo Vadis?

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