The Unique Features of Traumatic Brain Injury in Children. Review of the Characteristics of the Pediatric Skull and Brain, Mechanisms of Trauma, Patterns of Injury, Complications and Their Imaging Findings—Part 1

Pinto, Pedro Sá; Poretti, Andrea; Meoded, Avner; Tekes, Aylin; Huisman, Thierry A. G. M.

doi:10.1111/j.1552-6569.2011.00688.x

Cited by 87 publications

(60 citation statements)

References 73 publications

(94 reference statements)

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“…11 The high sensitivity of highresolution volume-rendered (VR) 3D CT in detecting skull fractures was reported in 6 pediatric human cadaver skulls after they were exposed to head drop tests. 8 The 3D data set can be made available by simple postprocessing techniques immediately after the 2D image acquisition and is a potential valuable source of information with no added cost, scan time, or radiation exposure.…”

Section: 16mentioning

confidence: 99%

Pediatric skull fracture diagnosis: should 3D CT reconstructions be added as routine imaging?

Orman¹,

Wagner²,

Seeburg³

et al. 2015

PED

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OBJECT The authors compared the efficacy of combining 2D+3D CT reconstructions with standard 2D CT images in the diagnosis of linear skull fractures in children with head trauma. METHODS This was a retrospective evaluation of consecutive head CT studies of children presenting with head trauma. Two experienced pediatric neuroradiologists in consensus created the standard of reference. Three readers independently evaluated the 2D CT images alone and then in combination with the 3D reconstructions for the diagnosis of linear skull fractures. Sensitivity and specificity in the diagnosis of linear skull fractures utilizing 2D and 2D+3D CT in combination were measured for children less than 2 years of age and for all children for analysis by the 3 readers. RESULTS Included in the study were 250 consecutive CT studies of 250 patients (167 boys and 83 girls). The mean age of the children was 7.82 years (range 4 days to 17.4 years). 2D+3D CT combined had a higher sensitivity and specificity (83.9% and 97.1%, respectively) compared with 2D alone (78.2% and 92.8%, respectively) with statistical significance for specificity (p < 0.05) in children less than 2 years of age. 2D+3D CT combined had a higher sensitivity and specificity (81.3% and 90.5%, respectively) compared with 2D alone (74.5% and 89.1%, respectively) with statistical significance for sensitivity (p < 0.05) in all children. CONCLUSIONS In this study, 2D+3D CT in combination showed increased sensitivity in the diagnosis of linear skull fractures in all children and increased specificity in children less than 2 years of age. In children less than 2 years of age, added confidence in the interpretation of fractures by distinguishing them from sutures may have a significant implication in the setting of nonaccidental trauma. Furthermore, 3D CT is available at no added cost, scan time, or radiation exposure, providing trainees and clinicians with limited experience an additional valuable tool for routine imaging of pediatric head trauma.

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Section: 16mentioning

confidence: 99%

Pediatric skull fracture diagnosis: should 3D CT reconstructions be added as routine imaging?

Orman¹,

Wagner²,

Seeburg³

et al. 2015

PED

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“…It is stated that the most vulnerable segment of the carotid artery is the most distal cervical segment before entering the carotid canal at the skull base. The mechanism was explained as: the stretching of the artery at the proximal cervical vertebral column with hyperflexion or extension or rotation of the neck causes intimal tears in the artery wall [1,2,6]. Subintimal tear in the arterial wall causes stenosis and thromboembolism; on the other hand, sub adventitial tear causes pseudo aneurysm formation and potential rupture [7].…”

Section: Discussionmentioning

confidence: 99%

“…These cases also have drawn attention due to concomitant severe damage to the regional vascular structures such as carotid artery [1,2]. In some cases, especially with skull base fractures and cervical vertebral column trauma; carotid artery dissections at the cervical segment can occur [3,4].…”

Section: Introductionmentioning

confidence: 99%

How do we Handle Traumatic Pediatric Carotid Artery Dissection?

Hazer¹

2017

JNSK

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The authors present a case of a 3-year-old boy with a right temporoparietal lobe infarction that developed a day after a fall from height. In the following radiodiagnostic investigation, Magnetic resonance (MR) angiography showed narrowing of the right cervical internal carotid artery (ICA) indicative of a cervical carotid dissection. With the aid of this case, the authors review the neuroimaging findings of traumatic carotid artery dissection and management of these cases in pediatric population.

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“…Younger children tend to have relatively larger and heavier heads in relation to the rest of the body when compared to adults [16,17], thereby increasing the risk for spinal cord injury at CCJ. For example, patient 15 in this study with non-accidental trauma and normal conventional CSC MRI findings had abnormal FA and MD values at the first two cervical levels.…”

Section: Groupmentioning

confidence: 98%