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("Child" OR "Pediatric") AND "Head Trauma"

Melissa S Puffenbarger, Fahd A Ahmad, Michelle Argent, Hongjie Gu, Charles Samson, Kimberly S Quayle, Jacqueline M Saito
OBJECTIVE: The purpose of this study was to determine if implementation of a Pediatric Emergency Care Applied Research Network (PECARN)-based closed head injury assessment tool could safely decrease computed tomography (CT) use for pediatric head injury evaluation at a non-pediatric community emergency department (ED). METHODS: A quality improvement project was initiated at a non-pediatric community ED to implement an institution-specific, Pediatric Emergency Care Applied Research Network (PECARN)-based Pediatric Closed Head Injury Assessment Tool...
November 14, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Stephen F Kralik, Nucharin Supakul, Isaac C Wu, Gaspar Delso, Rupa Radhakrishnan, Chang Y Ho, Karen A Eley
PURPOSE: The purpose of this study was to determine the accuracy of "black bone" (BB) MRI for the detection of skull fractures in children with potential abusive head trauma. METHODS: A total of 34 pediatric patients were evaluated for potential abusive head trauma. All patients had both a non-contrast head CT (HCT) with multiplanar reformatted images and 3D volumetric reformatted images where available (gold standard) for fracture diagnosis and BB of the head with multiplanar reformatted images and 3D volumetric images...
November 7, 2018: Neuroradiology
Krishnamoorthy Thamburaj, Ajay Soni, Lori D Frasier, Kyaw N Tun, Sarah R Weber, Mark S Dias
BACKGROUND: Retinal hemorrhages are one of the most important supportive evidences for abusive head trauma (AHT). Susceptibility-weighted imaging (SWI) is highly suited to identify various forms of intracranial hemorrhage in AHT. However its utility in imaging retinal hemorrhage is not well established. OBJECTIVE: SWI is a sensitive sequence for identifying retinal hemorrhage on MRI. MATERIALS AND METHODS: In this retrospective analysis, 26 consecutive infants and young children with a suspected admission diagnosis of AHT underwent indirect ophthalmoscopy and brain MRI protocol for AHT along with SWI...
November 3, 2018: Pediatric Radiology
Erika Moors Cornell, Elizabeth C Powell
BACKGROUND: Fractures are common in children, and it can be difficult to distinguish unintentional injuries from child abuse. OBJECTIVE: We describe circumstances of injury, prevalence of suspicion for physical abuse, and use of imaging to identify additional occult fractures in young children with femur fractures. METHODS: We reviewed the medical records for children younger than 48 months old with femur fractures treated at a pediatric referral hospital (2011-2013)...
October 30, 2018: Journal of Emergency Medicine
Abdulaziz O Almubarak, Abdulkarim S Al-Rabie, Rawan M Alsolami, Mohammaed M Homoud
Leptomeningeal cysts, which are cystic collections filled with cerebrospinal fluid, are rare complications following pediatric head trauma and surgical correction of craniosynostosis. These cysts develop due to cerebrospinal fluid pulsations and brain growth that cause expansion of the dural tears. Although primary repair of the dural defect is the definitive treatment, the risk of cyst recurrence remains. Factors that increase this risk include syndromic craniosynostosis, hydrocephalus, increased intracranial pressure, and inadequate duraplasty/cranioplasty...
October 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Guilherme Gozzoli Podolsky-Gondim, Luciano Lopes Furlanetti, Dinark Conceição Viana, Matheus Fernando Manzolli Ballestero, Ricardo Santos de Oliveira
INTRODUCTION: Head injury is a significant economic, social, and medical problem in developing countries and remains one of the leading causes of pediatric morbidity and mortality. The association of traumatic brain injury and coagulopathy in children is linked with an increase in mortality and poor functional outcomes. However, its impact on long-term outcome has not been discussed in the literature so far. OBJECTIVES: The aim of this paper was to investigate the effect of coagulopathy diagnosed by routine laboratory tests on neurological outcome following traumatic brain injury in children...
December 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Laura E Cowley, Daniel M Farewell, Alison M Kemp
BACKGROUND: The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) in children <3 years old with intracranial injury. OBJECTIVE: To explore the impact of PredAHT on clinicians' AHT probability estimates and child protection (CP) actions, and assess inter-rater agreement between their estimates and between their CP actions, before and after PredAHT. PARTICIPANTS AND SETTING: Twenty-nine clinicians from different specialties, at teaching and community hospitals...
October 9, 2018: Child Abuse & Neglect
Fadi Al Daoud, Anne Drolet, Chase Carto, Haben Debessai, Gul Sachwani Daswani
Introduction: Traumatic Brain Injuries (TBIs) can range from mild to severe, and may result in increased intracranial pressure (ICP). Increased ICP causes hallmark physical signs, such as diaphoresis, emesis, fixed pupils, and altered mental status. Monitoring the patient's score on the Glasgow Coma Scale (GCS) and cranial CT scans are routine measures used in clinical practice to monitor the development of a TBI. Presentation of the case: A 6-year-old male fell off his father's shoulders and subsequently presented to ED for suspected head trauma...
November 2018: Annals of Medicine and Surgery
Noam Gerber, Kelley Sookraj, Swapna Munnangi, L D George Angus, Vineet Lamba, Krishan Kumar, Brinda Doraiswamy
PURPOSE: To evaluate whether the emergency department usage of head computed tomography (CT) on pediatric patients with minor head trauma changed after publication of the Pediatric Emergency Care Applied Research Network (PECARN) head CT guidelines and to identify risk factors associated with performing head CT on patients without a PECARN guideline indication. METHODS: This retrospective study included 484 patients 18 years of age or younger who presented to the emergency department with head injury and a total Glasgow Coma Scale score ≥ 14 between September 2005 and July 2014...
September 27, 2018: Emergency Radiology
William T O'Brien, Marguerite M Caré, James L Leach
Pediatric head trauma is an important cause of morbidity and mortality in children and may be seen in the setting of accidental or abusive injuries. Although many of the patterns of head injury are similar to adults, the imaging manifestations of head injury in children are more complex due to the developing brain and calvarium. Additionally, there are unique considerations for mechanisms of injury in children, to include abusive head trauma and birth-related injuries. The primary role of the radiologist is to identify and characterize the type and severity of head injury to help guide appropriate patient management...
October 2018: Seminars in Ultrasound, CT, and MR
Ilaria Persico, Matteo Cesari, Alessandro Morandi, Justin Haas, Paolo Mazzola, Antonella Zambon, Giorgio Annoni, Giuseppe Bellelli
OBJECTIVES: To evaluate the relationship between frailty and delirium. DESIGN: Systematic review and meta-analysis. SETTING: MEDLINE, EMBASE, PubMed, Scopus, Web of Science, and Google Scholar databases were searched for articles on frailty and delirium published on or before October 31, 2017. PARTICIPANTS: Individuals aged 65 and older. MEASUREMENTS: Two authors independently reviewed all English-language citations, extracted relevant data, and assessed studies for potential bias...
October 2018: Journal of the American Geriatrics Society
Coralie Jacquet, Sergio Boetto, Annick Sevely, Jean-Christophe Sol, Yves Chaix, Emmanuel Cheuret
Head injury is the most common cause of child traumatology. However, there exist no treatment guidelines in children having intracranial lesions due to minor or moderate head trauma. There is little knowledge about monitoring, clinical exacerbation risk factors, or optimal duration of hospitalization. The aim of this retrospective study is to find predictive factors in the clinical course of non-severe head trauma in children, and thus to determine an optimal management strategy. Poor clinical progress was observed in only 4 out of 113 children...
December 2018: Neuropediatrics
Qingxiu Yao, Qiang Song, Hui Wang, Haibo Shi, Dongzhen Yu
OBJECTIVE: To describe the clinical features of benign paroxysmal positional vertigo (BPPV) in children. DESIGN: A retrospective study. SETTING: Six children diagnosed with BPPV between March 2014 and March 2015 were retrospectively evaluated. BPPV was diagnosed using the Dix-Hallpike and supine roll test and treated with either the modified Epley particle repositioning procedure or Lempert or Gufoni maneuver. Follow-up was performed at 1-week intervals until vertigo and nystagmus disappeared during positional testing...
September 16, 2018: Clinical Otolaryngology
Laura Carone, Rohan Ardley, Patrick Davies
INTRODUCTION: Traumatic injury is the leading cause of death in children after infancy. Almost 25% of all cyclists killed in the UK are children, and two thirds of these will die because of their head injuries. We compared the population of young people wearing helmets whilst cycling, to those admitted with serious post cycling head injuries to our paediatric critical care unit. METHOD: All children aged 0-18 years admitted to our intensive care following a bicycle accident between the years January 2011-June 2018 were identified and information on the mechanism of injury, and both immediate and long term clinical data were collected...
August 20, 2018: Injury
Marzieh Hajiaghamemar, Ingrid S Lan, Cindy W Christian, Brittany Coats, Susan S Margulies
Skull fractures are common injuries in young children, typically caused by accidental falls and child abuse. The paucity of detailed biomechanical data from real-world trauma in children has hampered development of biomechanical thresholds for skull fracture in infants. The objectives of this study were to identify biomechanical metrics to predict skull fracture, determine threshold values associated with fracture, and develop skull fracture risk curves for low-height falls in infants. To achieve these objectives, we utilized an integrated approach consisting of case evaluation, anthropomorphic reconstruction, and finite element simulation...
September 7, 2018: International Journal of Legal Medicine
Abigail Kleinschmidt
Child maltreatment is a serious public health concern in the United States. Young infants and children younger than 3 years are at the highest risk of being abused and can experience both acute injuries and long-term developmental, behavioral, and mental health problems. Health care providers are mandated reporters of suspected abuse but may misdiagnose potentially abusive injuries because of lack of knowledge in recognizing maltreatment. Premobile infants rarely have bruising or intraoral injuries without a reported accident or underlying systemic disease and should raise concern for abuse...
September 3, 2018: Journal of Pediatric Health Care
Meghann M Ronning, Patrick L Carolan, Gretchen J Cutler, Richard J Patterson
BACKGROUND: Abusive head trauma (AHT) is the most common cause of subdural hemorrhage (SDH) in infants younger than 12 months old. Clot formation in the parasagittal vertex seen on imaging has been associated with SDH due to AHT. There have been very few studies regarding these findings; to our knowledge, no studies including controls have been performed. OBJECTIVE: To describe parasagittal vertex clots on head computed tomography (CT) in infants with SDH and AHT compared to patients with SDH and accidental trauma, and to evaluate for parasagittal vertex clots in the absence of SDH in the setting of known accidental head trauma...
September 5, 2018: Pediatric Radiology
Ruth M Masterson Creber, Peter S Dayan, Nathan Kuppermann, Dustin W Ballard, Leah Tzimenatos, Evaline Alessandrini, Rakesh D Mistry, Jeffrey Hoffman, David R Vinson, Suzanne Bakken
BACKGROUND:  The overuse of cranial computed tomography (CT) to diagnose potential traumatic brain injuries (TBIs) exposes children with minor blunt head trauma to unnecessary ionizing radiation. The Pediatric Emergency Care Applied Research Network and the Clinical Research on Emergency Services and Treatments Network implemented TBI prediction rules via electronic health record (EHR) clinical decision support (CDS) to decrease use of CTs in children with minor blunt head trauma. OBJECTIVE:  This article aims to facilitate implementation and dissemination of a CDS alert into emergency departments around the country...
July 2018: Applied Clinical Informatics
Brett Burstein, Julia E M Upton, Heloisa Fuzaro Terra, Mark I Neuman
BACKGROUND AND OBJECTIVES: International efforts have been focused on identifying children at low risk of clinically important traumatic brain injury in whom computed tomography (CT) neuroimaging can be avoided. We sought to determine if CT use for pediatric head trauma has decreased among US emergency departments (EDs). METHODS: This was a cross-sectional analysis of the National Hospital Ambulatory Care Medical Survey database of nationally representative ED visits from 2007 to 2015...
October 2018: Pediatrics
Anne Laurent-Vannier, Catherine Adamsbaum, Jean-Sébastien Raul, Caroline Rey-Salmon, Caroline Rambaud
No abstract text is available yet for this article.
December 2018: Acta Paediatrica
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