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Abstract

Despite prevention efforts, pediatric head trauma remains the most common cause of serious injury and death in children. Seventy-five percent of children who are hospitalized secondary to trauma, sustain head trauma. Most pediatric head trauma is mild in severity, although central nervous system (CNS) injury is the most common cause of pediatric traumatic death [22]. The overall incidence is 200–300 cases per 100,000 in the population annually. Deaths from severe traumatic brain injury (TBI) occur at an alarming rate of 7,000 annually [20]. This is especially concerning when considering that upwards of 20–40% of the injuries are preventable. The financial burden on individuals and society is immense, and is estimated at $7.5 billion annually in the United States. Many childhood survivors of severe TBI are left with varying degrees of permanent disability.

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References

  1. Adelson PD, Clyde B, Kochanek PM, Wisniewski SR, Marion DW, Yonas H (1997) Cerebrovascular response in infants and young children following severe traumatic brain injury: a preliminary report. Pediatr Neurosurg 26:200–207

    PubMed  CAS  Google Scholar 

  2. Adelson PD, Bratton SL, Carney NA, Chestnut RM, Coudrey HE, Goldstein B, et al (2003) Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Pediatr Crit Care Med 31:S488–491

    Google Scholar 

  3. American Heart Association (2002) Pediatric Advanced Life Support. American Heart Association, Dallas

    Google Scholar 

  4. Andrews BT, Hammer GB (1997) The neurological examination and neurological monitoring in pediatric intensive care. In: Andrews BT, Hammer GB (eds) Pediatric neurosurgical intensive care. The American Association of Neurological Surgeons, Park Ridge, IL, pp 1–11

    Google Scholar 

  5. Barkovich AJ (2000) Pediatric neuroimaging (3rd edn). Lippincott, Philadelphia

    Google Scholar 

  6. Barkovich AJ (2005) Pediatric neuroimaging (4th ed). Lippincott, Philadelphia

    Google Scholar 

  7. Barlow KM, Thomson E, Johnson D, Minns RA (2001) Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy. Pediatrics 116:174–185

    Article  Google Scholar 

  8. Bayir H, Kochanek PM, Clar RSB (2003) Traumatic brain injury in infants and children: Mechanisms of secondary damage and treatment in the intensive care. Crit Care Clin 19:529–549

    Article  PubMed  Google Scholar 

  9. Berger RP, Dulani T, Adelson PD, Leventhal JM, Richichi R, Kochanek PM (2006) Indentification of inflicted traumatic brain injury in well-appearing infants using serum and cerebrospinal markers: a possible screening tool. Pediatrics 117:325–332

    Article  PubMed  Google Scholar 

  10. Bernard SA, Buist M (2003) Induced hypothermia in critical care medicine: a review. Crit Care Med 31:2041–2051

    Article  PubMed  Google Scholar 

  11. Biswas AK, Bruce DA, Sklar FH, Bokovoy JL, Sommerauer JF (2002) Treatment of acute traumatic brain injury in children with moderate hypothermia improves intracranial hypertension. Crit Care Med 30:2742–2751

    Article  PubMed  Google Scholar 

  12. Blackburn ST (2003) Assessment and management of the neurologic system. In: Kenner C, Lott JW (eds) Comprehensive neonatal nursing: a physiologic perspective (3rd edn). Saunders, Philadelphia, pp 650–651

    Google Scholar 

  13. Caffey J (1974) The whiplash shaken infant syndrome: manual shaking by the extremities with whiplash-induced intracranial and intraocular bleedings, linked with residual permanent brain damage and mental retardation. Pediatrics 54:396–403

    PubMed  CAS  Google Scholar 

  14. Carney NA, Chesnut R, Kochanek PM et al. (2003) Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Pediatr Crit Care Med 4:S1–S75

    Article  PubMed  Google Scholar 

  15. Cobbs-Ewing L, Kramer L, Prasad M, Canales DN, Louis PT, Fletcher JM, Vollero H, Landry SH, Cheung K (1998) Neuroimaging, physical, and developmental finding after inflicted and noninflicted traumatic brain injury in young children. Pediatrics 102:300–307

    Article  Google Scholar 

  16. Cochran A, Scaife E, Hansen KW, Downey ED (2003) Hyperglycemia and outcome from pediatric traumatic brain injury. J Trauma 55:1035–1038

    PubMed  Google Scholar 

  17. Curley MAQ, Quigley SM, Lin M (2003) Pressure ulcers in pediatric intensive care: incidence and associated factors. Pediatr Crit Care Med 4:284–290

    Article  PubMed  Google Scholar 

  18. Davis JD (2001) Neonatal subgaleal hemorrhage: diagnosis and management. CMAJ 164:1452–1453

    PubMed  CAS  Google Scholar 

  19. Dias MS (2004) Traumatic brain and spinal cord injury. Pediatr Clin N Am 51:271–303

    Article  Google Scholar 

  20. Duhaime AC (1999) Closed head injury without fractures. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and Practice of Pediatric Neurosurgery. Thieme, New York, pp 799–811

    Google Scholar 

  21. Fisher B, Thomas, D, Peterson B (1992) Hypertonic saline lowers raised ICP in children after head injury. J Neurosurg Anesthesiol 4:4–10

    Article  PubMed  CAS  Google Scholar 

  22. Greenberg, MS (2001) Handbook of Neurosurgery (5th edn). Thieme, New York

    Google Scholar 

  23. Hackbarth RM, Rzeszutko KM, Sturm G, Donders J, Kuldanek AS, Sanfilippo DJ (2002) Survival and functional outcome in pediatric traumatic brain injury: a retrospective review and analysis of predictive factors. Crit Care Med 30:1630–1635

    Article  PubMed  Google Scholar 

  24. Haitsma IS, Mass AIR (2002) Advanced monitoring in the intensive care unit: brain tissue oxygen tension. Curr Opin Crit Care 8:115–120

    Article  PubMed  Google Scholar 

  25. Hazinski MF (1999) Manual of Pediatric Critical Care. Mosby, St Louis

    Google Scholar 

  26. Hendrickson SL (1987) Intracranial pressure changes and family presence. J Neurosci Nurs 19:14–17

    PubMed  CAS  Google Scholar 

  27. Henker R, Brown S, Marion D (1998) Comparison of brain temperature with bladder and rectal temperatures in adults with severe head injury. Neurosurgery 42:1071–1075

    Article  PubMed  CAS  Google Scholar 

  28. Hernandez PW, Hernandez JA (1999) Physical assessment of the newborn. In: Thureen PJ, Deacon J, O’Neill P, Hernandez JA (eds) Assessment and Care of the Well Newborn. Saunders, Philadelphia, pp 114–162

    Google Scholar 

  29. Hettler J, Greenes DS (2003) Can the initial history predict whether a child with a head injury has been abused? Pediatrics 111:602–607

    Article  PubMed  Google Scholar 

  30. Hickey JV (2003) The Clinical Practice of Neurological and Neurosurgical Nursing (5th edn). Lippincott, Philadelphia

    Google Scholar 

  31. Hinton-Bayre AD, Geffen G (2002) Severity of sports-related concussion and neuropsychological test performance. Neurology 59:1068–1070

    PubMed  Google Scholar 

  32. Holmes JF, Palchak MJ, Conklin MJ, Kuppermann N (2004) Do children require hospitalization after immediate posttraumatic seizures? Ann Emerg Med 43:786–790

    Article  Google Scholar 

  33. Horan MJ (1987) Report of the Second Task Force on Blood Pressure Control in Children — 1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics 79:1

    Google Scholar 

  34. Jarvis C (1996) Pocket Companion for Physical Examination and Health Assessment (2nd edn). Saunders, Philadelphia

    Google Scholar 

  35. Jenny C, Hymel KP, Ritzen A, et al (1999) Analysis of missed cases of abusive head trauma. JAMA 281:621–626

    Article  PubMed  CAS  Google Scholar 

  36. Kelly JP, Rosenberg JH (1997) The diagnosis and management of concussion in sports American Academy of Neurology practice parameter. Neurology 48:575–585

    PubMed  CAS  Google Scholar 

  37. Kennedy CS, Moffatt M (2004) Acute traumatic brain injury in children: exploring the cutting edge in understanding, therapy, and research. Clin Pediatr Emerg Med 5:224–238

    Article  Google Scholar 

  38. Khanna S, Davis D, Peterson B, Fisher B, Fung H, O’Quigley J, et al (2000) Use of hypertonic saline in the treatment of severe refractory post traumatic intracranial hypertension in pediatric traumatic brain injury. Crit Care Med 28:1144–1150

    Article  PubMed  CAS  Google Scholar 

  39. Klauber MR, Marshall LF, Luerssen TG, Frankowski R, Tabaddor K, Eisenberg M (1989) Determinants of head injury mortality: importance of the low risk patient. Neurosurgery 24:31–36

    Article  PubMed  CAS  Google Scholar 

  40. Kochanek PM, Clark RS, Ruppel RA, Adelson PD, Bell MJ, Whalen MJ, et al (2000) Biochemical, cellular, and molecular mechanisms in the evolution of secondary damage after severe TBI in infants and children: lessons learned from the bedside. Pediatr Crit Care Med 1:4–19

    Article  PubMed  Google Scholar 

  41. Kokoska ER, Smith GS, Pittman T, Weber TR (1998) Early hypotension worsens neurological outcome in pediatric patients with moderately severe head trauma. J Pediatr Surg 33:333–338

    Article  PubMed  CAS  Google Scholar 

  42. Lam AM, Winn HR, Cullen BF, Sundling N (1991) Hyperglycemia and neurological outcome in patients with head injury. J Neurosurg 75:545–551

    PubMed  CAS  Google Scholar 

  43. Leker RR, McKay RDG (2004) Using endogenous neural stem cells to enhance recovery from ischemic brain injury. Curr Neurovasc Res 5:421–427

    Article  Google Scholar 

  44. Levy DI, Rekate HL, Cherny WB, Manwaring K, Moss SD, Baldwin HZ (1995) Controlled lumbar drainage in pediatric head injury. J Neurosurg 83:453–460

    PubMed  CAS  Google Scholar 

  45. Littlejohns LR, Bader MK, March K (2003) Brain tissue oxygen monitoring in severe brain injury: research and usefulness in critical care. Crit Care Nurs 23:17–25

    Google Scholar 

  46. Luerrsen TG (1999). Skull fractures after closed head injury. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and Practice of Pediatric Neurosurgery. Thieme, New York, pp 813–829

    Google Scholar 

  47. Luerrsen TG (2001) Acute traumatic cerebral injury. In: McLone DG, Marlin AE, Scott R, Steinbok P, Reigel DH, Walker ML, Cheek WR (eds) Pediatric Neurosurgery (4th edn). Saunders, Philadelphia, pp 601–619

    Google Scholar 

  48. Luerssen TG, Wolfla CE (1997) Pathophysiology and management of increased intracranial pressure in children. In: Andrews BT, Hammer GB (Eds) Pediatric Neurosurgical Intensive Care. American Association of Neurological Surgeons, Park Ridge, IL, pp 37–56

    Google Scholar 

  49. Luerssen TG, Klauber MR, Marshall LF (1988) Outcome from head injury related to patient’s age. A longitudinal prospective study of adult and pediatric head injury. J Neurosurg 68:409–416

    PubMed  CAS  Google Scholar 

  50. Lynam L, Verklan MT (2004) Neurological disorders. In: Verklan MT, Walden M (eds) Core curriculum for neonatal intensive care nursing (3rd edn). Saunders, Philadelphia

    Google Scholar 

  51. Mamelak AN, Pitts LH, Damron S (1996) Predicting survival from head trauma 24 hours after injury: a practical method with therapeutic implications. J Trauma Injury Infect Crit Care 41:91–99

    Article  CAS  Google Scholar 

  52. Marcoux KK (2005) Management of increased intracranial pressure in the critically ill child with an acute neurological injury. AACN Clin Issues 16:212–231

    Article  PubMed  Google Scholar 

  53. Marion DW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM, et al (1997) Treatment of traumatic brain injury with moderate hypothermia. New Engl J Med 336:540–546

    Article  PubMed  CAS  Google Scholar 

  54. Massagli TL, Jaffe KM (1994) Pediatric traumatic brain injury: prognosis and rehabilitation. Pediatr Ann 23:29–36

    PubMed  CAS  Google Scholar 

  55. Maugans TA, McComb JG, Levy ML (1999) Penetrating craniocerebral injuries. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and Practice of Pediatric Neurosurgery. Thieme, New York, pp 831–847

    Google Scholar 

  56. McCrory P, Johnston K, Meeuwisse W, Aubry M, Cantu R, Dvorak J, et al (2005) Summary and agreement statement of the second International Conference on Concussion in Sport, Prague 2004. Clin J Sport Med 15:48–55

    Article  PubMed  Google Scholar 

  57. Miller BF, Keane CB (1987) Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health (4th edn). Saunders, Philadelphia

    Google Scholar 

  58. Mitchell PH, Habermann-Little B, Johnson F, VanInwegen-Scott D, Tyler D (1985) Critically ill children: the importance of touch in a high-technology environment. Nurs Admin Q 9:38–46

    CAS  Google Scholar 

  59. Moe P, Paige PL (1998) Neurologic disorders. In: Merenstein G, Gardner S (eds) Handbook of Neonatal Intensive Care (4th edn). Mosby, St Louis

    Google Scholar 

  60. National Pediatric Trauma Registry Biannual Report (1999) Tufts University School of Medicine. New England Medical Center, Boston

    Google Scholar 

  61. Negishi H, Lee Y, Itoh K, Suzuki J, Nishino M, Takada S, Yamasaki S (1989) Neurosurgical management of epidural hematoma in neonates. Pediatr Neurol 5:253–256

    Article  PubMed  CAS  Google Scholar 

  62. Parker RS (2001) Concussive Brain Trauma — Neurobehavioral Impairment and Maladaptation. CRC Press, Boca Raton, Florida, pp 99–115

    Google Scholar 

  63. Patten J (1980) Neurological Differential Diagnosis. Springer-Verlag, New York

    Google Scholar 

  64. Pediatric Exclusivity Labeling Changes (2005, July 7) Retrieved August 23, 2005 from http://www.fda.gov/cder/pediatric/labelchange.htm

    Google Scholar 

  65. Peterson B, Khanna S, Fischer B, Marshall L (2000) Prolonged hypernatremia controls elevated ICP in head-injured pediatric patients. Crit Care Med 28:1136–1143

    Article  PubMed  CAS  Google Scholar 

  66. Phillips R, Ott L, Young B, Walsh J (1987) Nutritional support and measured energy expenditure of the child and adolescent with head injury. J Neurosurg 67:846–851

    PubMed  CAS  Google Scholar 

  67. Piqula FA, Wald SL, Shackford SR, Vane DW (1993) The effect of hypotension and hypoxia on children with severe head injuries. J Pediatr Surg 28:310–316

    Article  Google Scholar 

  68. Plum F, Posner JB (1982) The Diagnosis of Stupor and Coma (3rd edn). FA Davis, Philadelphia

    Google Scholar 

  69. Polderman KH, Joe RTT, Peerdeman SM, Vandertop WP, Girbes ARJ (2002) Effects of therapeutic hypothermia on intracranial pressure and outcome in patients with severe head injury. Intens Care Med 28:1563–1573

    Article  Google Scholar 

  70. Potoka DA, Schall LC, Gardner MJ, Stafford PW, Peitzman AB, Ford HR (2000) Impact of pediatric trauma centers on mortality in a statewide system. J Trauma 49:237–245

    Article  PubMed  CAS  Google Scholar 

  71. Ritter AM, Ward JD (1999). Mass lesions after head injury in the pediatric population. In: Albright AL, Pollack IF, Adelson PD (eds) Principles and Practice of Pediatric Neurosurgery. Thieme, New York, pp 849–859

    Google Scholar 

  72. Rovlias A, Kotsou S (2000) The influence of hyperglycemia on neurological outcome in patients with severe head injury. Neurosurgery 46:335–343

    Article  PubMed  CAS  Google Scholar 

  73. Sansoucie DA, Cavaliere TA (2003) Newborn and infant assessment. In: Kenner C, Lott JW (eds) Comprehensive Neonatal Nursing: a Physiologic Perspective (3rd edn). Saunders, Philadelphia, pp 650–651

    Google Scholar 

  74. Shaver E, Duhaime AC, Curtis M, Gennarelli LM, Barrett R (1996) Experimental acute subdural hematoma in infant piglets. Pediatr Neurosurg 25:123–129

    Article  PubMed  CAS  Google Scholar 

  75. Shiozaki T, Hayakata T, Taneda M, Nakajima Y, Haskiguchi N, Fujimi S, et al (2001) A multi-center prospective randomized trial of the efficacy of mild hypothermia for severely head injured patients with low intracranial pressure. J Neurosurg 94:50–54

    PubMed  CAS  Google Scholar 

  76. Shipley C (2006) Traumatic brain injury. Retrieved: March 25, 2006, www.trialimage.com

    Google Scholar 

  77. Simma B, Burger R, Falk M, Sacher P, Fanconi S (1998) A prospective randomized, and controlled study of fluid management in children with severe head injury: lactated ringer’s solution versus hypertonic saline. Crit Care Med 26:1265–1270

    Article  PubMed  CAS  Google Scholar 

  78. Skippen P, Seear M, Poskitt K, Kestle J, Cochrane D, Annich G, et al (1997) Effect of hyperventilation on regional cerebral blood flow in head-injured children. Crit Care Med 25:1275–1278

    Article  Google Scholar 

  79. Society for Neuroscience (2005) Traumatic brain injury and transplants. Retrieved from the Internet March 31, 2006, www.apu.sfn.org

    Google Scholar 

  80. Tatsumi K, Haga S, Matsuyoshi H, Inoue M, Manabe T, Makinodan M, Wanaka A (2005) Characterization of cells with proliferative activity after brain injury. Neurochem Int 46:381–389

    Article  PubMed  CAS  Google Scholar 

  81. Towbin A (1998) Brain Damage in the Newborn and its Neurologic Sequels. PRM Publishing, Danvers, MA

    Google Scholar 

  82. Vagnozzi R, Signoretti S, Tavazzi B, Cimatti M, Amorini AM, Donzelli R, Delfini R, Lazzarino G (2005) Hypothesis of the postconcussive vulnerable brain: experimental evidence of its metabolic occurrence. Neurosurgery 57:164–171

    Article  PubMed  Google Scholar 

  83. Valadka AB, Gopinath SP, Contant CF, Uzura M, Robinson CS (1998) Relationship of brain tissue PO2 to outcome after severe head injury. Crit Care Med 26:1576–1581

    Article  PubMed  CAS  Google Scholar 

  84. Vavilala MS, Lee LA, Boddu K, Visco E, Newell DW, Zimmerman JJ, Lam AM (2004) Cerebral autoregulation in pediatric traumatic brain injury. Pediatr Crit Care Med 5:257–263

    Article  PubMed  Google Scholar 

  85. Vinchon M, Dhellemmes SD, Desurmont M, Dhellemmes P (2005) Accidental and nonaccidental head injuries in infants: a prospective study. J Neurosurg Pediatr 102:380–384

    Google Scholar 

  86. Volpe JJ (2001) Neurology of the Newborn (4th edn). Saunders, Philadelphia

    Google Scholar 

  87. Wilson-Pauwels L, Akesson EJ, Stewart PA, Spacey SD (2002) Cranial Nerves in Health and Disease (2nd edn). BC Decker, Hamilton, Ontario

    Google Scholar 

  88. Young G, Ott L, Dempsey R, Haack D, Tibbs P (1989) Relationship between admission hyperglycemia and neurologic outcome of severely brain injured patients. Ann Surg 210:466–473

    Article  PubMed  CAS  Google Scholar 

  89. Young PA, Young PH (1997) Basic Clinical Neuroanatomy. Lippincott, Baltimore

    Google Scholar 

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Enix, A., Mullen, J., Green, C., Kahn, S. (2007). Traumatic Brain Injury. In: Cartwright, C.C., Wallace, D.C. (eds) Nursing Care of the Pediatric Neurosurgery Patient. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-29704-8_7

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