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Pediatric head brain trauma

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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
#1
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...
October 18, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/29967895/brain-death-in-children-incidence-donation-rates-and-the-occurrence-of-central-diabetes-insipidus
#14
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
#15
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
#16
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...
September 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29893520/calculated-decisions-pecarn-pediatric-head-injury-trauma-algorithm
#17
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
#18
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
#19
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
#20
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
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