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Pediatric head brain trauma

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https://www.readbyqxmd.com/read/30485240/using-an-artificial-neural-network-to-predict-traumatic-brain-injury
#1
(no author information available yet)
OBJECTIVEPediatric traumatic brain injury (TBI) is common, but not all injuries require hospitalization. A computational tool for ruling in patients who will have a clinically relevant TBI (CRTBI) would be valuable, providing an evidence-based way to safely discharge children who are at low risk for a CRTBI. The authors hypothesized that an artificial neural network (ANN) trained on clinical and radiologist-interpreted imaging metrics could provide a tool for identifying patients likely to suffer from a CRTBI...
October 1, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/30468627/pediatric-central-nervous-system-imaging-of-nonaccidental-trauma-beyond-subdural-hematomas
#2
Divya Gunda, Benjamin O Cornwell, Hisham M Dahmoush, Sammer Jazbeh, Anthony M Alleman
Infants and children under 2 years of age are at greatest risk for devastating neurologic complications following nonaccidental trauma. While a subdural hematoma (SDH) is the most common finding and is often enough to raise suspicion for abuse, no single injury is pathognomonic for abusive head trauma (AHT). Rather, the combination of imaging and physical findings and the clinical presentation help confirm the diagnosis of AHT. Familiarity with the spectrum of findings and proper identification of the imaging abnormalities is important for the radiologist to facilitate treatment and removal of the patient from the abusive environment...
November 23, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/30463714/to-scan-or-not-to-scan-overutilization-of-computed-tomography-for-minor-head-injury-at-a-pediatric-trauma-center
#3
Jeremy D Kauffman, Cristen N Litz, Sasha A Thiel, Anh Thy H Nguyen, Aaron Carey, Paul D Danielson, Nicole M Chandler
BACKGROUND: Degree of compliance with Pediatric Emergency Care Applied Research Network (PECARN) recommendations for radiographic evaluation following minor head injury in children is not well understood. The aim of this study was to assess PECARN compliance at a pediatric trauma center. The secondary aim was to determine whether children with indeterminate history of loss of consciousness (LOC) are at greater risk for clinically important traumatic brain injury (ciTBI) than those with no LOC...
December 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/30444861/change-in-functional-status-among-children-treated-in-the-intensive-care-unit-after-injury
#4
Omar Z Ahmed, Richard Holubkov, J Michael Dean, Tellen D Bennett, Kathleen L Meert, Robert A Berg, Christopher J L Newth, Joseph Carcillo, Randall S Burd, Murray M Pollack
BACKGROUND: Because pediatric trauma-related mortality continue to decline, metrics assessing morbidity are needed to evaluate the impact of treatment after injury. Based of its value for assessing children with traumatic brain injuries and other critical illnesses, Functional Status Scale (FSS), a tool that measures function in six domains (communication, feeding, mental, motor, sensory and respiratory), was evaluated as an outcome measure for the overall population of injured children...
November 15, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/30428150/reduction-of-computed-tomography-use-for-pediatric-closed-head-injury-evaluation-at-a-non-pediatric-community-emergency-department
#5
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
https://www.readbyqxmd.com/read/30392163/susceptibility-weighted-imaging-of-retinal-hemorrhages-in-abusive-head-trauma
#6
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
https://www.readbyqxmd.com/read/30351293/prevention-of-recurrence-post-leptomeningeal-cyst-repair
#7
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
https://www.readbyqxmd.com/read/30334071/the-role-of-coagulopathy-on-clinical-outcome-following-traumatic-brain-injury-in-children-analysis-of-66-consecutive-cases-in-a-single-center-institution
#8
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
https://www.readbyqxmd.com/read/30312251/risk-factors-for-avoidable-transfer-to-a-pediatric-trauma-center-among-patients-age-two-years-and-older
#9
Christopher W Snyder, Jeremy D Kauffman, Etienne E Pracht, Paul D Danielson, David J Ciesla, Nicole M Chandler
BACKGROUND: Effective and sustainable pediatric trauma care requires systems of regionalization and interfacility transfer. Avoidable transfer, also known as secondary overtriage, occurs when a patient is transferred to a regional trauma center after initial evaluation at another facility that is capable of providing definitive care. The purpose of this study was to identify risk factors for avoidable transfer among pediatric trauma patients in southwest Florida. METHODS: All pediatric trauma patients two years and older transferred from outlying hospitals to the emergency department (ED) of a single state-designated pediatric trauma center between 2009 and 2017 were obtained from the institutional registry...
October 11, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/30294436/absence-of-cognitive-symptoms-in-a-6-year-old-male-with-post-traumatic-increased-intracranial-pressure-a-case-report
#10
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
https://www.readbyqxmd.com/read/30244763/pediatric-emergencies-imaging-of-pediatric-head-trauma
#11
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
https://www.readbyqxmd.com/read/30184559/applying-the-re-aim-framework-for-the-evaluation-of-a-clinical-decision-support-tool-for-pediatric-head-trauma-a-mixed-methods-study
#12
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
https://www.readbyqxmd.com/read/30181120/use-of-ct-for-head-trauma-2007-2015
#13
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
https://www.readbyqxmd.com/read/30171446/enteral-nutrition-initiation-in-children-admitted-to-pediatric-intensive-care-units-after-traumatic-brain-injury
#14
Binod Balakrishnan, Katherine T Flynn-O'Brien, Pippa M Simpson, Mahua Dasgupta, Sheila J Hanson
BACKGROUND: Traumatic brain injury (TBI) is the leading cause of death and long-term disability among injured children. Early feeding has been shown to improve outcomes in adults, with some similar evidence in children with severe TBI. We aimed to examine the current practice of initiation of enteral nutrition in children with TBI and to evaluate the risk factors associated with delayed initiation of enteral nutrition. METHODS: This retrospective, multicenter study used the Pediatric Trauma Assessment and Management Database including all children with head trauma discharged from five pediatric intensive care units (PICU) at pediatric trauma centers between January 1, 2013 and December 31, 2013...
August 31, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/30090144/bull-horn-head-injury-with-retained-horn-in-brain-a-rare-case-report
#15
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
#16
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
#17
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...
August 2018: Pediatrics
https://www.readbyqxmd.com/read/30001441/traumatic-brain-injury-in-the-pediatric-intensive-care-unit
#18
REVIEW
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
#19
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
#20
James F Holmes, Peter S Dayan, Nathan Kuppermann
No abstract text is available yet for this article.
July 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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