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Pediatric head brain trauma

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https://www.readbyqxmd.com/read/30090144/bull-horn-head-injury-with-retained-horn-in-brain-a-rare-case-report
#1
Pavan Kumar, Vardan Kulshreshtha, Ashok Kumar, Gaurav Jaiswal, Tarun K Gupta
Pediatric head injuries are a commonly seen emergency in trauma centers worldwide. There are various modes of injury such as fall from height, road traffic accidents, objects hitting the head, assault, and battered baby. We report here a child who presented to us with a history of sustaining head injury by a stray bull on the road and a retained broken bull horn inside the brain and its subsequent management.
April 2018: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/30067188/validation-of-the-sainte-justine-head-trauma-pathway-for-children-younger-than-two-years-of-age
#2
Sarah Spénard, Sarah Gouin, Marianne Beaudin, Jocelyn Gravel
The Sainte-Justine Head Trauma Pathway helps physicians' decision-making in the evaluation of head trauma in young children. We evaluated the pathway to identify clinically important traumatic brain injury (ciTBI) among children younger than two years who presented to a pediatric emergency department for a head trauma. The primary outcome was ciTBI, defined as a TBI complicated by death, neurosurgery, intubation or hospitalization for more than one night. Among 2258 children, we reviewed the charts of all hospitalized children ( n = 100) and a random sample of nonhospitalized children ( n = 101) and found a ciTBI in 26 patients...
August 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/30037976/the-eye-examination-in-the-evaluation-of-child-abuse
#3
Cindy W Christian, Alex V Levin
Child abuse can cause injury to any part of the eye. The most common manifestations are retinal hemorrhages (RHs) in infants and young children with abusive head trauma (AHT). Although RHs are an important indicator of possible AHT, they are also found in other conditions. Distinguishing the number, type, location, and pattern of RHs is important in evaluating a differential diagnosis. Eye trauma can be seen in cases of physical abuse or AHT and may prompt referral for ophthalmologic assessment. Physicians have a responsibility to consider abuse in the differential diagnosis of pediatric eye trauma...
July 23, 2018: Pediatrics
https://www.readbyqxmd.com/read/30001441/traumatic-brain-injury-in-the-pediatric-intensive-care-unit
#4
Elora Hussain
Head trauma is a leading cause of brain injury in children, and it can have profound lifelong physical, cognitive, and behavioral consequences. Optimal acute care of children with traumatic brain injury (TBI) requires rapid stabilization and early neurosurgical evaluation by a multidisciplinary team. Meticulous attention is required to limit secondary brain injury after the initial trauma. This review discusses pathophysiology, acute stabilization, and monitoring, as well as supportive and therapeutic measures to help minimize ongoing brain injury and optimize recovery in children with TBI...
July 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29986857/validation-and-refinement-of-a-clinical-decision-rule-for-the-use-of-computed-tomography-in-children-with-minor-head-injury-in-the-emergency-department
#5
Martin H Osmond, Terry P Klassen, George A Wells, Jennifer Davidson, Rhonda Correll, Kathy Boutis, Gary Joubert, Serge Gouin, Simi Khangura, Troy Turner, Francois Belanger, Norm Silver, Brett Taylor, Janet Curran, Ian G Stiell
BACKGROUND: There is uncertainty about which children with minor head injury need to undergo computed tomography (CT). We sought to prospectively validate the accuracy and potential for refinement of a previously derived decision rule, Canadian Assessment of Tomography for Childhood Head injury (CATCH), to guide CT use in children with minor head injury. METHODS: This multicentre cohort study in 9 Canadian pediatric emergency departments prospectively enrolled children with blunt head trauma presenting with a Glasgow Coma Scale score of 13-15 and loss of consciousness, amnesia, disorientation, persistent vomiting or irritability...
July 9, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29971851/multiple-pediatric-head-injury-decision-rules-but-what-should-the-clinician-use
#6
James F Holmes, Peter S Dayan, Nathan Kuppermann
Traumatic brain injury (TBI) is the leading cause of traumatic death in children. As many children with TBIs have subtle symptoms and missed or delayed diagnoses may result in increased morbidity, emergency department clinicians must frequently determine which children require emergent cranial computed tomographic (CT) scanning even after apparently minor blunt head trauma. Overuse of CT scans, however, has important drawbacks, including radiation-induced malignancies. Two large cohorts have documented the association of cranial CT scanning with cancer in children...
July 3, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29967895/brain-death-in-children-incidence-donation-rates-and-the-occurrence-of-central-diabetes-insipidus
#7
Nazik Yener, Muhammed Şükrü Paksu, Özlem Köksoy
Introduction: Brain death is currently defined as the loss of full brain function including the brainstem. The diagnosis and its subsequent management in the pediatric population are still controversial. The aim of this study was to define the demographic characteristics, clinical features and outcomes of patients with brain death and determine the incidence of brain death, donation rates and occurrence of central diabetes insipidus accompanying brain death in children. Methods: This retrospective study was conducted at a twelve-bed tertiary-care combined medical and surgical pediatric intensive care unit of the Ondokuz Mayis University Medical School, Samsun, Turkey...
January 2018: Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29955138/risk-of-infection-and-sepsis-in-pediatric-patients-with-traumatic-brain-injury-admitted-to-hospital-following-major-trauma
#8
Anjli Pandya, Kathleen Helen Chaput, Andrea Schertzer, Diane Moser, Jonathan Guilfoyle, Sherry MacGillivray, Jaime Blackwood, Ari R Joffe, Graham C Thompson
Head injury accounts for 29% of all traumatic deaths in children. Sepsis is significantly associated with an increased risk of mortality in adult traumatic brain injury patients. In the pediatric population, this relationship is not well understood. The objective of this study was to compare the proportion of pediatric traumatic brain injury (TBI) patients and trauma patients without brain injury (NTBI) who developed sepsis or any infection during their index hospital admission. We performed a retrospective study of all trauma patients <18 years of age, admitted to trauma centres in Alberta, Canada from January 1, 2003 to December 31, 2012...
June 28, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29912812/multicenter-review-of-current-practices-associated-with-venous-thromboembolism-prophylaxis-in-pediatric-patients-after-trauma
#9
Amee M Bigelow, Katherine T Flynn-O'Brien, Pippa M Simpson, Mahua Dasgupta, Sheila J Hanson
OBJECTIVES: Frequency of venous thromboembolism in pediatric trauma patients admitted to PICUs is not insignificant, ranging up to 6%. Risk factors have been identified in this population. However, there is little consensus of actual venous thromboembolism prophylaxis practice. We examined factors associated with venous thromboembolism prophylaxis in PICUs. DESIGN: A retrospective study evaluating associations with mechanical venous thromboembolism prophylaxis, pharmacologic venous thromboembolism prophylaxis, or dual therapy (DUAL) prophylaxis compared with no venous thromboembolism prophylaxis...
June 15, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29893520/calculated-decisions-pecarn-pediatric-head-injury-trauma-algorithm
#10
Daniel Runde, Joshua Beiner
The PECARN Pediatric Head Injury Prediction Rule is a well-validated clinical decision aid that allows clinicians to safely rule out the presence of clinically important traumatic brain injuries.
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29882488/orbital-and-nasal-meningoencephaloceles-secondary-to-chronic-hydrocephalus-a-rare-cause-of-bilateral-proptosis
#11
Zachary B Jenner, Nuruddin Husein, Roy Riascos, Yoshua Esquenazi
Introduction Orbital meningoencephalocele formation is primarily a result of congenital defects in the pediatric population and trauma of the anterior cranial fossa in adults. We present a unique case of nontraumatic nasal and orbital meningoencephaloceles presenting as bilateral proptosis with exotropia secondary to chronic hydrocephalus. Clinical presentation A 20-year-old male with a history of tuberous sclerosis, X-linked intellectual disability, and epilepsy presented to the emergency department with two days of nausea, emesis, seizures, and two months of progressive proptosis...
August 2018: Neuroradiology Journal
https://www.readbyqxmd.com/read/29874782/trend-of-age-adjusted-rates-of-pediatric-traumatic-brain-injury-in-u-s-emergency-departments-from-2006-to-2013
#12
Cheng Chen, Jin Peng, Eric A Sribnick, Motao Zhu, Henry Xiang
Objective : To use the 2006⁻2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of age-adjusted rates of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments. Methods : Time trend analysis was conducted on age-adjusted rates among children ≤17 years in the U.S. The annual percent change (APC) was calculated by fitting a least squares regression to the logarithm of the rates, using the calendar year as an independent variable. Results : In males, motor-vehicle-related trauma (APC -2...
June 5, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29796153/head-ct-guidelines-following-concussion-among-the-youngest-trauma-patients-can-we-limit-radiation-exposure-following-traumatic-brain-injury
#13
Bryan J Harvell, Stephen D Helmer, Jeanette G Ward, Elizabeth Ablah, Raymond Grundmeyer, James M Haan
Introduction: Recent studies have provided guidelines on the use of head computed tomography (CT) scans in pediatric trauma patients. The purpose of this study was to identify the prevalence of these guidelines among concussed pediatric patients. Methods: A retrospective review was conducted of patients four years or younger with a concussion from blunt trauma. Demographics, head injury characteristics, clinical indicators for head CT scan (severe mechanism, physical exam findings of basilar skull fracture, non-frontal scalp hematoma, Glasgow Coma Scale score, loss of consciousness, neurologic deficit, altered mental status, vomiting, headache, amnesia, irritability, behavioral changes, seizures, lethargy), CT results, and hospital course were collected...
May 2018: Kansas journal of medicine
https://www.readbyqxmd.com/read/29784284/routine-surveillance-imaging-following-mild-traumatic-brain-injury-with-intracranial-hemorrhage-may-not-be-necessary
#14
Smruti K Patel, Yair M Gozal, Bryan M Krueger, James C Bayley, Suzanne Moody, Norberto Andaluz, Richard A Falcone, Karin S Bierbrauer
BACKGROUND: Mild traumatic brain injury (mTBI) comprises the majority of pediatric traumatic brain injury. Children with mTBI even with traumatic intracranial hemorrhage (tICH) rarely experience a clinically significant neurologic decline (CSND). The utility of routine surveillance imaging in the pediatric population also remains controversial, especially owing to concerns about the risks of radiation exposure at a young age. This study aims to identify demographic or injury-related characteristics that may facilitate recognition of children at risk of progression with mTBI...
April 27, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29760839/severely-elevated-blood-pressure-and-early-mortality-in-children-with-traumatic-brain-injuries-the-neglected-end-of-the-spectrum
#15
M Austin Johnson, Matthew A Borgman, Jeremy W Cannon, Nathan Kuppermann, Lucas P Neff
Introduction: In adults with traumatic brain injuries (TBI), hypotension and hypertension at presentation are associated with mortality. The effect of age-adjusted blood pressure in children with TBI has been insufficiently studied. We sought to determine if age-adjusted hypertension in children with severe TBI is associated with mortality. Methods: This was a retrospective analysis of the Department of Defense Trauma Registry (DoDTR) between 2001 and 2013. We included for analysis patients <18 years with severe TBI defined as Abbreviated Injury Severity (AIS) scores of the head ≥3...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29718002/vertebral-artery-dissection-masquerading-as-concussion-in-an-adolescent
#16
Gogi Kumar, Bryan Ludwig, Vipul V Patel
OBJECTIVE: Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke. METHODS: Review of the chart, peer review/discussion, and imaging interpretation. RESULTS: A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29700200/external-validation-of-the-pedibirn-clinical-prediction-rule-for-abusive-head-trauma
#17
Helena Pfeiffer, Anne Smith, Alison Mary Kemp, Laura Elizabeth Cowley, John A Cheek, Stuart R Dalziel, Meredith L Borland, Sharon O'Brien, Megan Bonisch, Jocelyn Neutze, Ed Oakley, Louise Crowe, Stephen J C Hearps, Mark D Lyttle, Silvia Bressan, Franz E Babl
BACKGROUND AND OBJECTIVES: A 4-variable abusive head trauma (AHT) clinical prediction rule (CPR) for use in the PICU was derived and validated for children <3 years of age by the Pediatric Brain Injury Research Network (PediBIRN). We aimed to externally validate PediBIRN as designed (PICU only) as well as using broader inclusion criteria (admitted children with head injuries). METHODS: This was a secondary analysis of a prospective multicenter study of pediatric head injuries at 5 Australian and New Zealand tertiary pediatric centers...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29694653/clinical-factors-predictive-of-traumatic-brain-injuries-in-case-of-mild-traumatic-brain-injury-in-children-case-control-study
#18
Widad Gueddari, Amine Ouardi, Sanaa Talbi, Sihem Salam, Abdelhadi Zineddine
BACKGROUND: Mild head injury (MHI) is very common in children and the problem is a lack of consensus criteria for the indication of a brain CT. OBJECTIVE: To determine predictors of cranio-cerebral lesions (CCL) in the case of MHI in children. METHODS: Case-control study over a period of 3 years. Included children aged 1 month to 15 years, were those admitted to the department of Pediatric Emergencies for MHI and had performed a brain CT. The principal outcome was the presence of traumatic brain injury...
July 2017: La Tunisie Médicale
https://www.readbyqxmd.com/read/29622594/clinical-prediction-rules-for-abusive-head-trauma-a-systematic-review
#19
Helena Pfeiffer, Louise Crowe, Alison Mary Kemp, Laura Elizabeth Cowley, Anne S Smith, Franz E Babl
OBJECTIVE: Misdiagnosis of abusive head trauma (AHT) has serious consequences for children and families. This systematic review identifies and compares clinical prediction rules (CPredRs) assisting clinicians in assessing suspected AHT. DESIGN: We searched MEDLINE, Embase, PubMed and Cochrane databases (January 1996 to August 2016). Externally validated CPredRs focusing on the detection of AHT in the clinical setting were included. RESULTS: Of 110 potential articles identified, three studies met the inclusion criteria: the Pediatric Brain Injury Research Network (PediBIRN) 4-Variable AHT CPredR, the Predicting Abusive Head Trauma (PredAHT) tool and the Pittsburgh Infant Brain Injury Score (PIBIS)...
August 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29622334/pediatric-major-head-injury-not-a-minor-problem
#20
REVIEW
Aaron N Leetch, Bryan Wilson
Traumatic brain injury is a highly prevalent and devastating cause of morbidity and mortality in children. A rapid, stepwise approach to the traumatized child should proceed, addressing life-threatening problems first. Management focuses on preventing secondary injury from physiologic extremes such as hypoxemia, hypotension, prolonged hyperventilation, temperature extremes, and rapid changes in cerebral blood flow. Initial Glasgow Coma Score, hyperglycemia, and imaging are often prognostic of outcome. Surgically amenable lesions should be evacuated promptly...
May 2018: Emergency Medicine Clinics of North America
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