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Pediatric traumatic brain injury

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https://www.readbyqxmd.com/read/29768294/a-pilot-study-to-reduce-computed-tomography-utilization-for-pediatric-mild-head-injury-in-the-emergency-department-using-a-clinical-decision-support-tool-and-a-structured-parent-discussion-tool
#1
Rakesh S Engineer, Seth R Podolsky, Baruch S Fertel, Purva Grover, Heather Jimenez, Erin L Simon, Courtney M Smalley
INTRODUCTION: The American College of Emergency Physicians embarked on the "Choosing Wisely" campaign to avoid computed tomographic (CT) scans in patients with minor head injury who are at low risk based on validated decision rules. We hypothesized that a Pediatric Mild Head Injury Care Path could be developed and implemented to reduce inappropriate CT utilization with support of a clinical decision support tool (CDST) and a structured parent discussion tool. METHODS: A quality improvement project was initiated for 9 weeks to reduce inappropriate CT utilization through 5 interventions: (1) engagement of leadership, (2) provider education, (3) incorporation of a parent discussion tool to guide discussion during the emergency department (ED) visit between the parent and the provider, (4) CDST embedded in the electronic medical record, and (5) importation of data into the note to drive compliance...
May 15, 2018: Pediatric Emergency Care
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
#2
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/29757076/economic-evaluation-of-concussion-programs-in-the-state-of-idaho-the-collective-potential-of-prevention-and-clinical-care
#3
Susie Bergeron, Hilary Flint, Zeynep Hansen
Concussion, or mild traumatic brain injury, especially among young children, teenagers, and young adults, is a significant problem in Ada County, Idaho, and the United States. Although much has been learned about concussion, considerable controversy and gaps in knowledge still exist in many areas of research, leading to variation in concussion assessment, treatment, and management protocols. Health systems can positively impact concussion outcomes through community education and outreach, and provision of timely, coordinated, evidence-based clinical care...
May 14, 2018: Population Health Management
https://www.readbyqxmd.com/read/29756534/neurostimulant-prescribing-patterns-in-children-admitted-to-the-icu-after-traumatic-brain-injury
#4
Amanda Marie Morrison, Amy Houtrow, James Zullo, Patrick M Kochanek, Carol Vetterly, Ericka L Fink
Neurostimulant medications are commonly prescribed following traumatic brain injury (TBI) in adults; little is known about their use in children with TBI. Our objective was to analyze neurostimulant prescribing practices from 2005 to 2015 in children admitted to the intensive care unit (ICU) with TBI. We hypothesized that neurostimulant prescriptions have increased over time and are associated with older age and injury severity. A retrospective cohort study of patients aged 1 month to 18 years with an ICD-9-CM discharge diagnosis code for TBI admitted to the ICU between 2005 and 2015 in 37 pediatric hospitals included in the Pediatric Health Information System was conducted...
May 14, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29753521/emergency-department-implementation-of-the-centers-for-disease-control-and-prevention-pediatric-mild-traumatic-brain-injury-guideline-recommendations
#5
EDITORIAL
Angela Lumba-Brown, David W Wright, Kelly Sarmiento, Debra Houry
No abstract text is available yet for this article.
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29743771/cervical-myelopathy-in-a-child-a-rare-cause-of-hypoventilation-syndrome-presenting-with-type-2-respiratory-failure
#6
Alolika Mondal, Prabhas Prasun Giri
Hypoventilation syndrome leading to Type 2 respiratory failure is not a rare cause of Pediatric Intensive Care Unit admission and mechanical ventilation. Common causes in pediatric population are Guillain-Barre syndrome and various central nervous system disorders such as encephalitis, traumatic brain injury, and drugs. Any injury or disease in the cervical cord can also produce respiratory paralysis causing respiratory failure. Here, we present two cases of mixed cerebral palsy with cervical myelopathy due to compression effect of fractured segments of first and second cervical vertebrae...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29743575/delayed-and-progressive-damages-to-juvenile-mice-after-moderate-traumatic-brain-injury
#7
Shu Zhao, Xiaoting Wang, Xiang Gao, Jinhui Chen
Symptoms are commonly more severe in pediatric traumatic brain injury (TBI) patients than in young adult TBI patients. To understand the mechanism, juvenile mice received a controlled cortical impact (CCI) injury at moderate level. Tissue lesion and cell death were measured and compared to our previous reports on brain injury in the young adult mice that received same level of impact using same injury device. Tissue lesion and cell death in the cortex was much less in the juvenile mouse brain in the first few hours after injury...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29739276/corpus-callosum-vasculature-predicts-white-matter-microstructure-abnormalities-following-pediatric-mild-traumatic-brain-injury
#8
Kara M Wendel, Jeong Bin Lee, Bethann Affeldt, Mary Hamer, Indira S Harahap-Carrillo, Andrea C Pardo, Andre Obenaus
Emerging data suggest that pediatric traumatic brain injury (TBI) is associated with impaired developmental plasticity and poorer neuropsychological outcomes than adults with similar head injuries. Unlike adult mild TBI (mTBI), the effects of mTBI on white matter (WM) microstructure and vascular supply are not well-understood in the pediatric population. The cerebral vasculature plays an important role providing necessary nutrients and removing waste. To address this critical element, we examined the microstructure of the corpus callosum (CC) following pediatric mTBI using diffusion tensor imaging (DTI), and investigated myelin, oligodendrocytes, and vasculature of WM with immunohistochemistry...
May 9, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29738554/repeated-mild-traumatic-brain-injury-can-cause-acute-neurologic-impairment-without-overt-structural-damage-in-juvenile-rats
#9
Alicia Meconi, Ryan C Wortman, David K Wright, Katie J Neale, Melissa Clarkson, Sandy R Shultz, Brian R Christie
Repeated concussion is becoming increasingly recognized as a serious public health concern around the world. Moreover, there is a greater awareness amongst health professionals of the potential for repeated pediatric concussions to detrimentally alter the structure and function of the developing brain. To better study this issue, we developed an awake closed head injury (ACHI) model that enabled repeated concussions to be performed reliably and reproducibly in juvenile rats. A neurological assessment protocol (NAP) score was generated immediately after each ACHI to help quantify the cumulative effects of repeated injury on level of consciousness, and basic motor and reflexive capacity...
2018: PloS One
https://www.readbyqxmd.com/read/29725174/clinico-radiologic-profile-of-pediatric-traumatic-brain-injury-in-western-rajasthan
#10
Pawan Kumar Dara, Manish Parakh, Shyama Choudhary, Hemant Jangid, Priyanka Kumari, Satyendra Khichar
Objective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI). Design: Prospective observational study. Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. S. N. Medical College, Jodhpur (tertiary care hospital). Participants: A total of 188 children (1 month-18 years) were enrolled and 108 admitted. Intervention: TBI classified as mild, moderate, or severe TBI...
April 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29717626/the-moderating-effect-of-ankk1-on-the-association-of-family-environment-with-longitudinal-executive-function-following-traumatic-brain-injury-in-early-childhood-a-preliminary-study
#11
Julia Smith-Paine, Shari L Wade, Amery Treble-Barna, Nanhua Zhang, Huaiyu Zang, Lisa J Martin, Keith Owen Yeates, H Gerry Taylor, Brad G Kurowski
This study examined whether the ankyrin repeat and kinase domain containing 1 gene (ANKK1) C/T single-nucleotide polymorphism (SNP) rs1800497 moderated the association of family environment with long-term executive function (EF) following traumatic injury in early childhood. Caregivers of children with traumatic brain injury (TBI) and children with orthopedic injury (OI) completed the Behavior Rating Inventory of Executive Function (BRIEF) at post injury visits. DNA was collected to identify the rs1800497 genotype in the ANKK1 gene...
May 2, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29716980/the-biomarker-s100b-and-mild-traumatic-brain-injury-a-meta-analysis
#12
REVIEW
Charlotte Oris, Bruno Pereira, Julie Durif, Jeanne Simon-Pimmel, Christoph Castellani, Sergio Manzano, Vincent Sapin, Damien Bouvier
CONTEXT: The usefulness of S100B has been noted as a biomarker in the management of mild traumatic brain injury (mTBI) in adults. However, S100B efficacy as a biomarker in children has previously been relatively unclear. OBJECTIVE: A meta-analysis is conducted to assess the prognostic value of S100B in predicting intracerebral lesions in children after mTBI. DATA SOURCES: Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, and Google Scholar...
May 1, 2018: Pediatrics
https://www.readbyqxmd.com/read/29705573/the-long-term-outcomes-of-sport-related-concussion-in-pediatric-populations
#13
R Davis Moore, Jacob J Kay, Dave Ellemberg
Although the field of concussion research is rapidly growing, the majority of research has focused on injured adults, with children being an often-neglected population (Kirkwood et al., 2006). Traumatic brain injury is a leading cause of death and disability in children (Langlois et al., 2003), with over 1.5 million cases being treated in North America annually (Yeates et al., 1999). Approximately 75% of these injuries are classified as a concussion (Faul et al., 2010). Further, children are disproportionately affected by sports-related injuries, with 65% of all pediatric concussions occurring during sport and recreation (CDC, 2007)...
April 26, 2018: International Journal of Psychophysiology
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
#14
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/29683728/healthcare-providers-attitudes-and-behaviours-related-to-paediatric-mild-traumatic-brain-injury-results-from-the-2014-docstyles-survey
#15
Kelly Sarmiento, Zoe Donnell, Rosanne Hoffman, Bethany Tennant
OBJECTIVE: Explore healthcare providers' experiences managing mTBI and better understand their use of mTBI assessment tools and guidelines. Cross-sectional Methods: A random sample of 1,760 healthcare providers responded to the web-based DocStyles survey between June 18 and 30, 2014. The sample included family/general practitioners, internists, pediatricians, and nurse practitioners who reported seeing pediatric patients. We examined their experiences with mTBI to identify opportunities to increase preparedness and improve management of mTBI...
April 23, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29678928/imaging-in-pediatric-concussion-a-systematic-review
#16
REVIEW
Julia Schmidt, Kathryn S Hayward, Katlyn E Brown, Jill G Zwicker, Jennie Ponsford, Paul van Donkelaar, Shelina Babul, Lara A Boyd
CONTEXT: Pediatric mild traumatic brain injury (mTBI) is a common and poorly understood injury. Neuroimaging may index brain injury and outcome after pediatric mTBI, but remains largely unexplored. OBJECTIVE: To investigate the differences in neuroimaging findings in children/youth with mTBI. Measures of behavior, symptoms, time since injury, and age at injury were also considered. DATA SOURCES: A systematic review was conducted up to July 6, 2016...
April 20, 2018: Pediatrics
https://www.readbyqxmd.com/read/29676680/midline-central-fluid-percussion-model-of-traumatic-brain-injury-in-pediatric-and-adolescent-rats
#17
Rachel K Rowe, Jordan L Harrison, Timothy W Ellis, P David Adelson, Jonathan Lifshitz
OBJECTIVE Experimental traumatic brain injury (TBI) models hold significant validity to the human condition, with each model replicating a subset of clinical features and symptoms. TBI is the leading cause of mortality and morbidity in children and teenagers; thus, it is critical to develop preclinical models of these ages to test emerging treatments. Midline fluid percussion injury (FPI) might best represent mild and diffuse clinical brain injury because of the acute behavioral deficits, the late onset of behavioral morbidities, and the absence of gross histopathology...
April 20, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29676679/principles-of-system-design-not-realized-for-pediatric-craniospinal-trauma-care-in-the-united-states
#18
Joseph Piatt
OBJECTIVE An implicit expectation of the pioneers of trauma system design was that high clinical volume at select centers could lead to superior outcomes. There has been little study of the regionalization of pediatric craniospinal trauma care, and whether it continues to trend in the direction of regionalization is unknown. The motivating hypothesis for this study was that trauma system design in the United States is proceeding on a rational basis, producing hospital caseloads that are increasing over time and, because of geographic siting appropriate to the needs of catchment areas, in an increasingly uniform manner...
April 20, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29675071/pediatric-head-injury-a-study-of-403-cases-in-a-tertiary-care-hospital-in-a-developing-country
#19
Abrar Ahad Wani, Arif Hussain Sarmast, Muzaffar Ahangar, Nayil Khursheed Malik, Sarabjit Singh Chhibber, Sajad Hussain Arif, Altaf Umar Ramzan, Bashir Ahmed Dar, Zulfiqar Ali
Introduction: Traumatic brain injury (TBI) in children is a significant cause of morbidity and mortality worldwide. Falls are the most common type of injury, followed by motor vehicle-related accidents and child abuse. Aims and Objectives: The aim and objective of this study was to elucidate the various modes of injury, prognostic factors, complications, incidence of various modes of injury, and outcome in TBI in pediatric population. Materials and Methods: Patients with TBI, 18 years or less in age, managed in our Department of Neurosurgery, over a period of 2 years, were studied prospectively...
October 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29674994/a-cross-sectional-study-on-cerebral-hemodynamics-after-mild-traumatic-brain-injury-in-a-pediatric-population
#20
Corey M Thibeault, Samuel Thorpe, Michael J O'Brien, Nicolas Canac, Mina Ranjbaran, Ilyas Patanam, Artin Sarraf, James LeVangie, Fabien Scalzo, Seth J Wilk, Ramon Diaz-Arrastia, Robert B Hamilton
The microvasculature is prominently affected by traumatic brain injury (TBI), including mild TBI (concussion). Assessment of cerebral hemodynamics shows promise as biomarkers of TBI, and may help inform development of therapies aimed at promoting neurologic recovery. The objective of this study was to assess the evolution in cerebral hemodynamics observable with transcranial Doppler (TCD) ultrasound in subjects suffering from a concussion at different intervals during recovery. Pediatric subjects between the ages of 14 and 19 years clinically diagnosed with a concussion were observed at different points post-injury...
2018: Frontiers in Neurology
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