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Pediatric head injury

Maria Punchak, Jihad Abdelgadir, Oscar Obiga, Martha Itait, Josephine N Najjuma, Michael M Haglund, David Kitya
BACKGROUND: RTIs, falls and violence contribute to more than two thirds of pediatric TBIs in SSA. In this study, we sought to assess mechanisms of pediatric TBI in an effort to propose interventions for more effective pediatric head injury prevention. METHODS: A cohort of 100 patients who were <18 years treated at MRRH between November 2016 and June 2017 were enrolled in the study. Information on etiology of injury was obtained via a questionnaire administered to patient caretakers at the time of admission...
March 9, 2018: World Neurosurgery
Joseph R Starnes, Purnima Unni, Cherie A Fathy, Kelly A Harms, Shelby R Payne, Dai H Chung
BACKGROUND: Golf cart injuries represent an increasing source of morbidity and mortality in the United States. Characterization of the circumstances of these injuries can inform injury prevention efforts. METHODS: This study retrospectively reviews a prospective trauma registry at a level-one pediatric trauma center for golf cart-related injuries in patients under 18years of age admitted to the hospital between 2008 and 2016. RESULTS: The 40 identified crashes were associated with 82 hospital days, 17 ICU days, and more than $1 million in hospital charges over the study period...
March 2, 2018: American Journal of Emergency Medicine
Shaylan K Govind, Neil H Merritt
BACKGROUND: The objective of our study was to identify the most common mechanisms of injury leading to death in our pediatric population. METHODS: A retrospective cohort of fatally injured children 0-17 years old treated at our trauma center during 2000-2015. RESULTS: The mortality rate in our population was 8% (n = 103). Fifty-five percent were male. The majority (76%) of fatal injuries were blunt. Overall, motor vehicle collisions (MVCs) were the most common mechanism of injury (61%), followed by assault/abuse (9%)...
March 6, 2018: American Journal of Surgery
Saeed Kayhanian, Adam M H Young, Rory J Piper, Joseph Donnelly, Daniel Scoffings, Matthew R Garnett, Helen M Fernandes, Peter Smielewski, Marek Czosnyka, Peter J Hutchinson, Shruti Agrawal
Radiological assessment of the head is a routine part of the management of traumatic brain injury. This assessment can help to determine the requirement for invasive intracranial pressure (ICP) monitoring. The radiological correlates of elevated ICP have been widely studied in adults but far fewer specific pediatric studies have been conducted. There is, however, growing evidence that there are important differences in the radiological presentations of elevated ICP between children and adults; a reflection of the anatomical and physiological differences, as well as a difference in the pathophysiology of brain injury in children...
2018: Frontiers in Pediatrics
Yangyang R Yu, Annalyn S DeMello, Christopher S Greeley, Charles S Cox, Bindi J Naik-Mathuria, David E Wesson
PURPOSE: This study examines non-accidental trauma (NAT) fatalities as a percentage of all injury fatalities and identifies injury patterns in NAT admissions to two level 1 pediatric trauma centers. METHODS: We reviewed all children (<5years old) treated for NAT from 2011 to 2015. Patient demographics, injury sites, and survival were obtained from both institutional trauma registries. RESULTS: Of 4623 trauma admissions, 557 (12%) were due to NAT...
February 10, 2018: Journal of Pediatric Surgery
Ali Gemici, Aysegul Alkilic, Pinar Guleryuz, Selcuk Tunali, Betul Orhan Kilic, Pınar Ozisik
AIM: To discuss a special type of skull lesion detected after delivery. We reviewed our experience on scalp swelling in term neonates to further investigate the relationship between cranial injuries and labour process. MATERIAL AND METHODS: A total of 55 Newborns with scalp swellings were assessed with medical records retrospectively between January 2007- July 2017. A radiologist and a pediatric neurosurgeon reanalyzed all skull X-ray images via picture archiving and communication system of the hospital Results: A special type of skull fracture, called Kanat (wing) fracture was detected...
February 4, 2018: Turkish Neurosurgery
Ramazan Giden, Mehmet T Gokdemir, Ozcan Erel, Hasan Buyukaslan, Hamza Karabag
BACKGROUND: Oxidative stress may induce brain injury. Thiols are one of the most important antioxidant agents, and thiol/disulphide (SH/SS) homeo stasis is a novel oxidative stress marker. The goal of the study was to investigate the relationship of thiol levels and SH/SS homeostasis with head trauma in pediatric patients. METHODS: This prospective study was conducted in 85 consecutive pediatric patients aged < 18 years with isolated head trauma and 58 age- and gender-matched healthy controls in the Emergency Department (ED)...
January 1, 2018: Clinical Laboratory
Ajit Sarnaik, Nikki Miller Ferguson, A M Iqbal O'Meara, Shruti Agrawal, Akash Deep, Sandra Buttram, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Monica S Vavilala
BACKGROUND: Although small series have suggested that younger age is associated with less favorable outcome after severe traumatic brain injury (TBI), confounders and biases have limited our understanding of this relationship. We hypothesized that there would be an association between age and mortality in children within an ongoing observational, cohort study. METHODS: The first 200 subjects from the Approaches and Decisions for Acute Pediatric TBI trial were eligible for this analysis (inclusion criteria: severe TBI (Glasgow Coma Scale [GCS] score ≤ 8], age 18 years, and intracranial pressure (ICP) monitor placed; exclusion: pregnancy)...
February 23, 2018: Neurocritical Care
Nozomi Idota, Mami Nakamura, Misa Tojo, Hiroaki Ichioka, Kaori Shintani-Ishida, Hiroshi Ikegaya
An 11-month-old boy with marked abdominal distension was found dead in the prone position at home. Since there were many bruises in the non-protruding regions of the head, face, and abdomen, a medicolegal autopsy was performed the following day. The boy was smaller than average (height: 68.5 cm; weight: 7.8 kg); his extremities were thin; and his abdomen was remarkably bulging. Chylous ascites (1600 mL) was observed in the peritoneal cavity and chylous pleural effusion (left: 5 mL; right: 10 mL) in the thoracic cavity...
February 16, 2018: Legal Medicine
Amy L McIntosh, Christy M Christophersen
Motocross is a popular sport in which participants ride a two-wheeled, motorized vehicle on an uneven 2-km track with natural or human-made obstacles. Participants compete at high rates of speed, and children as young as age 4 years compete in age-appropriate groups. Motocross is recognized as a strenuous sport with a high accident rate. Most injuries are musculoskeletal in nature. The most commonly injured areas are the forearm, clavicle, femur, and tibia. Many injuries require surgical treatment. Some patients sustain head trauma with loss of consciousness...
March 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
Joshua B Brown, Mark L Gestring, Christine M Leeper, Jason L Sperry, Andrew B Peitzman, Timothy R Billiar, Barbara A Gaines
BACKGROUND: Children suffering non-accidental trauma (NAT) are at high risk of death. It is unclear whether markers of injury severity for trauma center/system benchmarking such as injury severity score (ISS) adequately characterize this. Our objective was to evaluate mortality prediction of ISS in children with NAT compared to accidental trauma (AT). METHODS: Pediatric patients age<16years from the Pennsylvania state trauma registry 2000-2013 were included. Logistic regression predicted mortality from ISS for NAT and AT patients...
February 17, 2018: Journal of Trauma and Acute Care Surgery
Victor S Alvarez, Svein Kleiven
Finite element (FE) models are a powerful tool that can be used to understand injury mechanisms and develop better safety systems. This study aims to extend the understanding of pediatric spine biomechanics, where there is a paucity of studies available. A newly developed and continuously scalable FE model was validated and scaled to 1.5-, 3-, 6-, 10-, 14- and 18-year-old using a non-linear scaling technique, accounting for local topological changes. The oldest and youngest ages were also scaled using homogeneous geometric scaling...
February 8, 2018: Journal of Biomechanics
Franz E Babl, Ed Oakley, Stuart R Dalziel, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Susan Donath, Stephen Hearps, Charlotte Molesworth, Louise Crowe, Silvia Bressan, Mark D Lyttle
STUDY OBJECTIVE: Three clinical decision rules for head injuries in children (Pediatric Emergency Care Applied Research Network [PECARN], Canadian Assessment of Tomography for Childhood Head Injury [CATCH], and Children's Head Injury Algorithm for the Prediction of Important Clinical Events [CHALICE]) have been shown to have high performance accuracy. The utility of any of these in a particular setting depends on preexisting clinician accuracy. We therefore assess the accuracy of clinician practice in detecting clinically important traumatic brain injury...
February 13, 2018: Annals of Emergency Medicine
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
Jackson Fein, David Bogumil, Jeffrey S Upperman, Rita V Burke
BACKGROUND: Previous studies have identified risk factors for dog bites in children, but use data from individual trauma centers, with limited generalizability. This study identifies a population risk profile for pediatric dog bites using the National Trauma Data Bank. We hypothesized that the population at risk was younger boys, that such bites occur at home, are moderately severe, and are on the face or neck. METHODS: For this retrospective cross-sectional study, a sample of 7912 children 17 years old and younger with International Classification of Diseases (ICD)-9 event code E906...
February 8, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Tara Rhine, Shari L Wade, Nanhua Zhang, Huaiyu Zang, Stephanie Kennebeck, Lynn Babcock
OBJECTIVES: Care decisions for young children presenting to the emergency department (ED) with head injury are often challenging (e.g. whether to obtain neuroimaging). We sought to identify factors associated with acute management of children at-risk for clinically important traumatic brain injury (ciTBI) and describe symptom management. METHODS: Observational evaluation of children, ages 0-4years, presenting to a pediatric ED following minor head injury. Children with ≥1 risk element per the Pediatric Emergency Care Academic Research Network's decision rule were deemed "at-risk" for ciTBI...
January 31, 2018: American Journal of Emergency Medicine
Przemyslaw Wolak, Andrzej Wincewicz, Anna Porębska, Stanislaw Sulkowski, Agnieszka Wincewicz-Price, Jonathan Price
Professor Zofia Umiastowska Sawicka laid the foundations for modern pediatric surgery in Poland, first in Bialystok, and subsequently in Kielce. She was a student of Prof. Jan Kossakowski from Warsaw Medical University to be counted among his most talented and skilled disciples. Professor Umiastowska became the head of the first Department of Pediatric Surgery in Bialystok, which was later incorporated into the Medical Academy of Bialystok. In 1977 she moved to Kielce to run the Department of Pediatric Surgery until her retirement in 1991...
December 2017: Acta Medico-historica Adriatica: AMHA
Henry T Puls, James D Anderst, Jessica L Bettenhausen, Abbey Masonbrink, Jessica L Markham, Laura Plencner, Molly Krager, Matthew B Johnson, Jacqueline M Walker, Christopher S Greeley, Matthew Hall
OBJECTIVES: To compare rates of previous inpatient visits among children hospitalized with child physical abuse (CPA) with controls as well as between individual abuse types. METHODS: In this study, we used the Pediatric Health Information System administrative database of 44 children's hospitals. Children <6 years of age hospitalized with CPA between January 1, 2011, and September 30, 2015, were identified by discharge codes and propensity matched to accidental injury controls...
January 25, 2018: Hospital Pediatrics
Elizabeth Meinert, Michael J Bell, Sandra Buttram, Patrick M Kochanek, Goundappa K Balasubramani, Stephen R Wisniewski, P David Adelson
OBJECTIVES: To understand the relationship between the timing of initiation of nutritional support in children with severe traumatic brain injury and outcomes. DESIGN: Secondary analysis of a randomized, controlled trial of therapeutic hypothermia (Pediatric Traumatic Brain Injury Consortium: Hypothermia, also known as "the Cool Kids Trial" (NCT 00222742). SETTINGS: Fifteen clinical sites in the United States, Australia, and New Zealand. SUBJECTS: Inclusion criteria included 1) age less than 18 years, 2) postresuscitation Glasgow Coma Scale less than or equal to 8, 3) Glasgow Coma Scale motor score less than 6, and 4) available to be randomized within 6 hours after injury...
January 24, 2018: Pediatric Critical Care Medicine
JongChan Ryu, Seong Jong Yun, Sun Hwa Lee, Yoon Hee Choi
OBJECTIVES: Facial bone fractures secondary to head trauma are more common in children than in adults. Recently, multidetector row computed tomography (CT) has been considered superior to conventional radiography. Some studies have reported that facial soft tissue injuries require both facial and brain CT and that brain CT is helpful in screening facial bone fractures. However, these studies included only adult patients. The aim of this study was to evaluate the diagnostic performance of brain CT and the need for additional facial CT to detect facial bone fractures in emergency pediatrics...
January 23, 2018: Pediatric Emergency Care
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