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Pediatric brain injury

Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Megan J Leonhard, Dagan A Wright, Rongwei Fu, David P Lehrfeld, Kathleen F Carlson
BACKGROUND: Traumatic brain injury (TBI) greatly contributes to morbidity and mortality in the pediatric population. We examined potential urban/rural disparities in mortality amongst Oregon pediatric patients with TBI treated in trauma hospitals. METHODS: We conducted a retrospective study of children ages 0-19 using the Oregon Trauma Registry for years 2009-2012. Geographic location of injury was classified using the National Center for Health Statistics Urban/Rural Classification Scheme...
December 2015: Injury Epidemiology
Ruchi Kaushik, Isabelle M Krisch, Darrell R Schroeder, Randall Flick, Michael E Nemergut
BACKGROUND: Head injuries are the leading cause of death among cyclists, 85 % of which can be prevented by wearing a bicycle helmet. This study aims to estimate the incidence of pediatric bicycle-related injuries in Olmsted County and assess differences in injuries between those wearing helmets vs. not. METHODS: Olmsted County, Minnesota residents 5 to 18 years of age with a diagnostic code consistent with an injury associated with the use of a bicycle between January 1, 2002, and December 31, 2011, were identified...
December 2015: Injury Epidemiology
Ashley Blanchard, Keven I Cabrera, Nathan Kuppermann, Peter S Dayan
OBJECTIVES: We aimed to determine the prevalence of and adverse outcomes caused by pneumocephali in children with minor blunt head trauma who had no other intracranial injuries (ie, isolated pneumocephali). METHODS: We conducted a secondary analysis of a public use dataset from a multicenter prospective study of pediatric minor head trauma. We included children younger than 18 years with Glasgow Coma Scale (GCS) scores of 14 or 15 and non-trivial mechanisms of injury who had cranial computed tomographies obtained...
October 6, 2016: Pediatric Emergency Care
Ursula I Tuor, Min Qiao, Manasi Sule, Melissa Morgunov, Tadeusz Foniok
Stroke is a major cause of disability in adults and children. Recently, we have developed an adult rat model of minor stroke containing a peri-infarct region with a modest T2 increase and mild ischemic damage. We hypothesized that a neonatal minor stroke with mild peri-ischemic changes could also be produced, but with potential ontogenic differences. Using our minor photothrombosis method, we produced a range of severities of ischemic lesions (mini, minor, moderate and severe) within magnetic resonance imaging (MRI) slices of adult and neonatal rats...
October 12, 2016: NMR in Biomedicine
Rounak B Rawal, Lauren A Kilpatrick, Jeyhan S Wood, Amelia F Drake
OBJECTIVE: To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities. METHODS AND MATERIALS: A modified Delphi approach was used to gather search terms. Search settings included "all jury verdicts and settlements", with jurisdiction of "all states" and "all federal courts" (by court and circuit). A retrospective review of WestLawNext legal database was conducted. Cases were excluded if they did not have a direct association from the patient's craniofacial anomaly or if they were not related to malpractice...
November 2016: International Journal of Pediatric Otorhinolaryngology
Weihong Yuan, Artur Meller, Joshua S Shimony, Tiffany Nash, Blaise V Jones, Scott K Holland, Mekibib Altaye, Holly Barnard, Jannel Phillips, Stephanie Powell, Robert C McKinstry, David D Limbrick, Akila Rajagopal, Francesco T Mangano
Neuroimaging research in surgically treated pediatric hydrocephalus patients remains challenging due to the artifact caused by programmable shunt. Our previous study has demonstrated significant alterations in the whole brain white matter structural connectivity based on diffusion tensor imaging (DTI) and graph theoretical analysis in children with hydrocephalus prior to surgery or in surgically treated children without programmable shunts. This study seeks to investigate the impact of brain injury on the topological features in the left hemisphere, contratelateral to the shunt placement, which will avoid the influence of shunt artifacts and makes further group comparisons feasible for children with programmable shunt valves...
2016: NeuroImage: Clinical
Kenneth Chin, Joshua M Abzug, Donald S Bae, Bernard D Horn, Martin Herman, Craig P Eberson
Management of pediatric polytrauma patients is one of the most difficult challenges for orthopaedic surgeons. Multisystem injuries frequently include complex orthopaedic surgical problems that require intervention. The physiology and anatomy of children and adolescent trauma patients differ from the physiology and anatomy of an adult trauma patient, which alters the types of injuries sustained and the ideal methods for management. Errors of pediatric polytrauma care are included in two broad categories: missed injuries and inadequate fracture treatment...
February 15, 2016: Instructional Course Lectures
Hakan Aylanç, Filiz Tütüncüler, Necdet Süt
BACKGROUND: This study was to determine whether pituitary dysfunction occurs after head trauma in children or not and which axis is affected more; to define the association of pituitary dysfunction with the severity of head trauma and duration time after the diagnosis of head trauma. MATERIALS AND METHODS: In this study, 24 children who were diagnosed with head trauma were evaluated regarding pituitary dysfunction. In all cases, after 12 h fasting, serum cortisol, fT3, fT4, thyroid-stimulating hormone, prolactin, insulin-like growth factor-1, serum sodium, urine density, follicle-stimulating hormone, luteinizing hormone, in female cases E2, in male cases, TT levels were determined...
October 2016: Journal of Neurosciences in Rural Practice
Marsh Königs, Wouter D Weeda, L W Ernest van Heurn, R Jeroen Vermeulen, J Carel Goslings, Jan S K Luitse, Bwee Tien Poll-The, Anita Beelen, Marleen van der Wees, Rachèl J J K Kemps, Coriene E Catsman-Berrevoets, Jaap Oosterlaan
Objective: To investigate the impact of pediatric traumatic brain injury (TBI) on multisensory integration in relation to general neurocognitive functioning. Method: Children with a hospital admission for TBI aged between 6 and 13 years (n = 94) were compared with children with trauma control (TC) injuries (n = 39), while differentiating between mild TBI without risk factors for complicated TBI (mildRF-; n = 19), mild TBI with ≥1 risk factor (mildRF+; n = 45), and moderate/severe TBI (n = 30). We measured set-shifting performance based on visual information (visual shift condition) and set-shifting performance based on audiovisual information, requiring multisensory integration (audiovisual shift condition)...
September 29, 2016: Neuropsychology
Angela Hein Ciccia, Jennifer P Lundine, Alyssa Coreno
Purpose: Access to speech-language pathology (SLP) services is a critical variable in the rehabilitation of pediatric brain injury. In this study, we examined patterns of SLP referral and factors affecting referral during the acute period following brain injury in 2 large pediatric specialty hospitals. Method: In a retrospective, cohort chart review study, data collection focused on referrals made during the acute period using International Classification of Diseases, Ninth Revision, Clinical Modification codes for primary diagnoses of brain injury between 2007 and 2014 (Centers for Disease Control and Prevention [CDC], 2014)...
September 28, 2016: American Journal of Speech-language Pathology
K Drorit Gaines, Henry V Soper
Assessment of executive functions in the adult is best captured at the stage where full maturation of brain development occurs. Assessment of executive functions of children, however, is considerably more complicated. First, assessment of executive functioning in children represents a snapshot of these developing functions at a particular time linked stage, which may have implications for further development. Second, neuropsychological measures available to assess executive functions in children are limited in number and scope and may not be sensitive to the gradual developmental changes...
September 27, 2016: Applied Neuropsychology. Child
Kirsten Morrissey, Hilary Fairbrother
More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. Early identification and management of severe traumatic brain injury is crucial in decreasing the risk of secondary brain injury and optimizing outcome. The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes...
October 2016: Pediatric Emergency Medicine Practice
Lyndal Hickey, Vicki Anderson, Brigid Jordan
This article describes a new and innovative social work intervention, Family Forward, designed to promote early adaptation of the family system after the onset of a child's acquired brain injury. Family Forward is integrated into inpatient rehabilitation services provided to the injured child and recognizes the important role of family in child rehabilitation outcomes and the parallel process of recovery for the child and family following an injury. Family Forward is informed by clinical practice, existing research in family adaptation after pediatric acquired brain injury, the resiliency model of family adjustment and adaptation, and family therapy theories and approaches...
August 15, 2016: Journal of Social Work in Disability & Rehabilitation
Jennifer B Christy, Michele A Lobo, Kristie Bjornson, Stacey C Dusing, Edelle Field-Fote, Mary Gannotti, Jill C Heathcock, Margaret E OʼNeil, James H Rimmer
Advances in technology show promise as tools to optimize functional mobility, independence, and participation in infants and children with motor disability due to brain injury. Although technologies are often used in adult rehabilitation, these have not been widely applied to rehabilitation of infants and children. In October 2015, the Academy of Pediatric Physical Therapy sponsored Research Summit IV, "Innovations in Technology for Children With Brain Insults: Maximizing Outcomes." The summit included pediatric physical therapist researchers, experts from other scientific fields, funding agencies, and consumers...
2016: Pediatric Physical Therapy
J Stephens, C Salorio, M Denckla, S Mostofsky, S Suskauer
Pediatric traumatic brain injury (TBI) is a heterogeneous condition, varying in both severity and sequelae. The long-term motor deficits following severe TBI requiring inpatient rehabilitation are better established than those following milder forms of TBI. The authors examined motor performance 2 and 12 months postinjury in children without overt motor impairment using standard measures of upper limb function and the Physical and Neurological Examination for Subtle Signs (PANESS). The PANESS was sensitive to differences between children with TBI and uninjured children as well as to changes in children with TBI over time...
September 16, 2016: Journal of Motor Behavior
Alicia J Spittle, Jennifer L McGinley, Deanne Thompson, Ross Clark, Tara L FitzGerald, Benjamin F Mentiplay, Katherine J Lee, Joy E Olsen, Alice Burnett, Karli Treyvaud, Elisha Josev, Bonnie Alexander, Claire E Kelly, Lex W Doyle, Peter J Anderson, Jeanie Ly Cheong
INTRODUCTION: Motor impairments are one of the most frequently reported adverse neurodevelopmental consequences in children born < 30 weeks' gestation. Up to 15% of children born at < 30 weeks have cerebral palsy and an additional 50% have mild to severe motor impairment at school age. The first 5 years of life are critical for the development of fundamental motor skills. These skills form the basis for more complex skills that are required to competently and confidently participate in schooling, sporting and recreational activities...
October 2016: Journal of Physiotherapy
Megan E Narad, Keith O Yeates, H Gerry Taylor, Terry Stancin, Shari L Wade
OBJECTIVE : Examine differences in maternal and paternal coping and distress following traumatic brain injury (TBI) and orthopedic injuries (OI).  METHOD : Concurrent cohort/prospective design with five assessments between 1 and an average of 7 years after injury of children aged 3-6 years hospitalized for TBI (n = 87) or OI (n = 119). Mixed models analyses were used to examine hypotheses. RESULTS : Overall, fathers reported greater depression and general distress than mothers 18 months after injury, but not at long-term follow-up...
September 15, 2016: Journal of Pediatric Psychology
Fabian Güiza, Bart Depreitere, Ian Piper, Giuseppe Citerio, Philippe G Jorens, Andrew Maas, Martin U Schuhmann, Tsz-Yan Milly Lo, Rob Donald, Patricia Jones, Gottlieb Maier, Greet Van den Berghe, Geert Meyfroidt
OBJECTIVE: A model for early detection of episodes of increased intracranial pressure in traumatic brain injury patients has been previously developed and validated based on retrospective adult patient data from the multicenter Brain-IT database. The purpose of the present study is to validate this early detection model in different cohorts of recently treated adult and pediatric traumatic brain injury patients. DESIGN: Prognostic modeling. Noninterventional, observational, retrospective study...
September 14, 2016: Critical Care Medicine
Simone Gazzellini, Antonio Napolitano, Graziella Bauleo, Eleonora Bisozzi, Maria Luisa Lispi, Eleonora Ardu, Enrico Castelli, Francesco Benso
PURPOSE: The literature on patients with attention deficit reports peculiar reaction time (RT) oscillation at very low frequencies (VLFO=0.06-0.2 Hz). The data were explained as default mode network (DMN) intrusion in goal-oriented activity. The present study investigates whether a pattern of recurrent lapses in attention can be detected in TBI patients and whether VLFO can be generalized to the sustained attention deficit, regardless of etiology. METHODS: Groups of pediatric TBIs and healthy controls performed four attentional tasks...
September 14, 2016: Developmental Neurorehabilitation
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