Abstract
Aim
This article focuses on the developments that occurred during the last two decades in the management of pediatric head injury. It describes the changes in incidence, various advancements in diagnosis, management, prognosis, prevention and strategies required for better outcome, and control of head injury.
Materials and methods
Thorough evaluation of various papers, research, and our experience revealed that in developed countries, there has been a decreasing trend in head trauma incidence and trauma-related deaths as compared to developing countries.
Results
This is mainly attributed to the widespread implementation of preventive measures. The development in imaging facilities, better characterization and grading of severe trauma (see, for example, diffuse axonal injury), an advanced understanding of the pathophysiology of secondary brain injury, endocrinological disturbances, predictive factors of outcome, development in neurophysiological monitoring, management advances in critical care units, implementation of safely measures, etc. have brought a significant change in overall outcome and profile of pediatric head injury
Conclusion
The further developments in field of brain plasticity, stem cell, rehabilitation, evolution of new drugs, preventive community measures, and global policies to deal with head trauma are expected to play a major role in days to come. The development of future pediatric trauma centers based on current evolutions (in order to achieve a good outcome), global and emphatic preventions of trauma will be required to establish equilibrium between developed and developing countries.
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References
Murray CJL, Lopez AD (1994) Global and regional cause of death patterns in 1990. Bull World Health Organ 72:447–480
Kumar R, Mahapatra AK (2005) Head injury in children. In: Mahapatra AK, Raj Kamal (eds) Textbook of head injury, 3rd edn. Modern Publishers, New Delhi, pp 253–270
WHO (1995).The World Health Report 1995. Report of the Director-General WHO
Rahman MR (2008) Child lab, 2001. Our-present scenario. Internet edition 2008, pp 1–4
Durkin MS, Laraque D, Lubman I, Barlow B (1999) Epidemiology and prevention of traffic injuries to urban children and adolescents. Pediatrics 103(6):74–78
Durkin MS, Olsen S, Barlow B, Virella A, Comnolly ES Jr (1998) The epidemiology of urban pediatric neurological trauma: evaluation of and implication for ,injury prevention programs. Neurosurgery 42:300–310
US Department of Transportation, National Highway Traffic safety Administration (1994) Occupant protection idea sampler. US Department of Transportation, Washington, DC
Walker ML, Storrs BB, Mayer TA (1985) Head injuries. In: Mayer TA (ed) Emergency management of pediatric trauma, 2nd edn. Saunders, Philadelphia, pp 272–286
Tullos M, Walker ML, Wright LC (1992) Evaluation and treatment of head injuries in children. In: Fuhrman BP, Zimmerman JJ (eds) Pediatric critical care, 3rd edn. St. Louis, Mosby, pp 1165–1182
Lundar T, Netsvold K (1985) Pediatric head injuries caused by road traffic accidents. Child Nerv Syst 1:24–28
Hahn YS, Chyung C, Barthel MJ, Bailes J (1988) Head injuries in children under 36 months of age. Demographics and outcome. Childs Nerv Syst 4:34–40
Merten DF, Osborne DRS, Rakowski MA (1984) Craniocerebral trauma in the child abuse syndrome: radiological observations. Pediatr Radiol 14:272–277
Fingerhut LA, Kleinman JC, Godfrey E (1991) Firearm mortality among children, youth,and young adults 1 to 34 years of age. Trends and current status: United States, 1979–88. Mon Vital Stat Rep 39(11 Suppl):1–16
Krause JF, Fife D, Controy C (1987) Pediatric brain injuries: the nature, clinical course, and early outcomes in a defined United States population. Pediatrics 79:501–507
Heffez DS, Ducker TB (1995) Fractures and dislocations of the pediatric spine. In: Pang D (ed) Disorders of the pediatric spine. Raven, New York, pp 517–529
Roddy SP, Cohn SM, Moller BA (1998) Minimal head trauma in children revisited is routine hospitalization required? Pediatrics 101:575–577
Kay A, Teasdale G (2001) Head Injury in the United Kingdom. World J Surg 25:1210–1220
Burce DA (2000) Imaging after head trauma: why, when and which. Child Nervous Syst 16:755–759
Menon DK, Minhas PS, Mathews JC, Downew SDMJ, Parry DA, Kendall IV, Williams EJ, Lawerence R, Turner C, Algbrihio FI, Carpenter TA, Clark JC, Pickard JD (1999) Spatial and temporal metabolic heterogeneity following head injury revealed by PET (abstract). J Cereb Blood Flow Metab 19:1
Marion DW, Spiegel TP (2000) Changes in the management of severe traumatic brain injury: 1991–1997. Crit Care Med 28:16–18
Kelly DF, Becker DP (2001) Advances in management of neurosurgical trauma: USA and Canada. World J Surg 25:1179–1185
Bourna GJ, Muizelaar JP, Stringer WA, Choi SC, Fatouros P, Young HF (1992) Ultra-early evaluation of regional cerebral blood flow in severely head injured patients using Xenon-enhanced computerized tomography. J Neurosurg 77:360–368
Arfanakis K, Haughton VM, Carew JD, Rogers BP, Dempsly RJ, Meyerland ME (2002) Diffusion tensor MR imaging in diffuse axonal injury. Am J Neuroradiol 23:794–802
Hutchison JS, Ward RE, Lacroix J, Hébert PC, Barnes MA, Bohn DJ, Dirks PB, Doucette S, Fergusson D, Gottesman R, Joffe AR, Kirpalani HM, Meyer PG, Morris KP, Moher D, Singh RN, Skippen PW, Hypothermia Pediatric Head Injury Trial Investigators and the Canadian Critical Care Trials Group (2008) Hypothermia therapy after traumatic brain injury in children. N Engl J Med 358(23):2447–2456
Kumar R, Mahapatra AK (2008) Minor Head Injury. Indian J Neurotrauma 2(5):59–62
Behan LA, Phillips J, Thompson CJ, Agha A (2008) Neuroendocrine disorder after TBI. J Neurol Neurosurg Psychiatry 79(7):753–759
Harangi BS, Kompanje EJ, Leebeck FW, Mars AI (2008) Coagulation disorders in traumatic brain injury. Acta Neurochir (Wien) 150(2):165–175
Schunk JE, Rodergerson JD, Woodward GA (1996) The utility of head computed tomographic scanning in pediatric patients with normal neurologic examination in the emergency depertment. Pediatr Emerg Care 12:160–165
Maejima S, Katayama Y (2001) Neursurgical trauma in Japan. World J Surg 25:1205–1209
Denoghue JP (2002) Connecting cortex to machines: recent advances in brain interfaces. Nat Neurosci 5(Suppl):1085–1088
Mock C, Lormand JD, Goosen J, Joshipura M (2004) Guidelines for essential trauma care. World Health Organization, Geneva, pp 1–10
Kalmar K, Novack TA, Nakase-Richardson R, Sherer M, Frol AB, Gordon WA, Hanks RA, Giacino JT, Ricker JH (2008) Feasibility of brief neuropsychological testing during acute patient rehabilitation after traumatic brain injury. Arch Phys Med Rehabil 89(5):942–949
Gururaj G (2002) Injuries in India: a national perspective. NCMH Background Papers—Burden of disease in India, pp 325–347
Klauber MR, Marshall LF, Toole BM, Knowlton SL, Bowers SA (1985) Cause of decline in head-injury mortality rate in San Diego County, California. J Neurosurg 62:528–531
Colohan AR, Alves WM, Gross CR, Torner JC, Mehta VS, Tandon PN, Jane JA (1989) Head injury mortality in two centers with different emergency medical services and intensive care. J Neurosurg 71:202–207
WHO April (2002) Strategic plan for injury prevention and control in Southeast Asia 2002. WHO Project ICP DPR 001, Regional Office for Southeast Asia, New Delhi, pp 1–18
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Kumar, R., Mahapatra, A.K. The changing “epidemiology” of pediatric head injury and its impact on the daily clinical practice. Childs Nerv Syst 25, 813–823 (2009). https://doi.org/10.1007/s00381-009-0820-z
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DOI: https://doi.org/10.1007/s00381-009-0820-z