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Traumatic brain injury in children

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https://www.readbyqxmd.com/read/28813241/should-potential-risk-of-chronic-traumatic-encephalopathy-be-discussed-with-young-athletes
#1
Kimberly Hornbeck, Kevin Walter, Matthew Myrvik
As participation in youth sports has risen over the past two decades, so has the incidence of youth sports injuries. A common topic of concern is concussion, or mild traumatic brain injury, in young athletes and whether concussions sustained at a young age could lead to lifelong impairment such as chronic traumatic encephalopathy (CTE). While the pathway from a concussed young athlete to an adult with CTE remains unknown, current research is attempting to provide more clarity. This article discusses how health care professionals can help foster an informed, balanced decision-making process regarding participation in contact sports that involves the parents as well as the children...
July 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28811137/influence-of-guidelines-on-management-of-paediatric-mild-traumatic-brain-injury-ct-assessment-and-admission-policy
#2
J J Lenstra, A R A Pikstra, J M Fock, Z Metting, J van der Naalt
BACKGROUND: The annual number of paediatric injury-related emergency visits and application of computed tomography (CT) has substantially increased, with associated higher risk of malignancies. In 2010, a guideline for CT-assessment based on risk factors for patients with mild traumatic brain injury (mTBI) became effective in all Emergency Departments (ED) in the Netherlands. This study evaluated the influence of this guideline on the frequency of CT-assessments, hospital admissions and factors that are related to guideline adherence...
August 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28808845/targeted-treatment-in-severe-traumatic-brain-injury-in-the-age-of-precision-medicine
#3
Anthony A Figaji, A Graham Fieggen, Ncedile Mankahla, Nico Enslin, Ursula K Rohlwink
In recent years, much progress has been made in our understanding of traumatic brain injury (TBI). Clinical outcomes have progressively improved, but evidence-based guidelines for how we manage patients remain surprisingly weak. The problem is that the many interventions and strategies that have been investigated in randomized controlled trials have all disappointed. These include many concepts that had become standard care in TBI. And that is just for adult TBI; in children, the situation is even worse. Not only is pediatric care more difficult than adult care because physiological norms change with age, but also there is less evidence for clinical practice...
August 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28783305/core-cross-linked-nanoparticles-reduce-neuroinflammation-and-improve-outcome-in-a-mouse-model-of-traumatic-brain-injury
#4
Dasom Yoo, Alexander W Magsam, Abby M Kelly, Patrick S Stayton, Forrest M Kievit, Anthony J Convertine
Traumatic brain injury (TBI) is the leading cause of death and disability in children and young adults, yet there are currently no treatments available that prevent the secondary spread of damage beyond the initial insult. The chronic progression of this secondary injury is in part caused by the release of reactive oxygen species (ROS) into surrounding normal brain. Thus, treatments that can enter the brain and reduce the spread of ROS should improve outcome from TBI. Here a highly versatile, reproducible, and scalable method to synthesize core-cross-linked nanoparticles (NPs) from polysorbate 80 (PS80) using a combination of thiol-ene and thiol-Michael chemistry is described...
August 16, 2017: ACS Nano
https://www.readbyqxmd.com/read/28780927/white-matter-microstructure-predicts-longitudinal-social-cognitive-outcomes-after-paediatric-traumatic-brain-injury-a-diffusion-tensor-imaging-study
#5
N P Ryan, S Genc, M H Beauchamp, K O Yeates, S Hearps, C Catroppa, V A Anderson, T J Silk
BACKGROUND: Deficits in social cognition may be among the most profound and disabling sequelae of paediatric traumatic brain injury (TBI); however, the neuroanatomical correlates of longitudinal outcomes in this domain remain unexplored. This study aimed to characterize social cognitive outcomes longitudinally after paediatric TBI, and to evaluate the use of sub-acute diffusion tensor imaging (DTI) to predict these outcomes. METHODS: The sample included 52 children with mild complex-severe TBI who were assessed on cognitive theory of mind (ToM), pragmatic language and affective ToM at 6- and 24-months post-injury...
August 7, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28762893/overlapping-microrna-expression-in-saliva-and-cerebrospinal-fluid-accurately-identifies-pediatric-traumatic-brain-injury
#6
Steven Daniel Hicks, Jeremiah Johnson, Molly C Carney, Harry Bramley, Robert P Olympia, Andrea C Loeffert, Neal J Thomas
Objectives To assess the accuracy and physiologic relevance of circulating microRNA (miRNA) as a biomarker of pediatric concussion, we compared changes in salivary miRNA and cerebrospinal fluid (CSF) miRNA following childhood traumatic brain injury (TBI). Study Design A case-cohort design was used to compare longitudinal miRNA concentrations in CSF of seven children with severe TBI against three controls without TBI. The miRNAs "altered" in CSF were interrogated in saliva of 60 children with mild TBI and compared with 18 age- and gender- matched controls...
August 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28745861/mass-spectrometric-imaging-of-ceramides-tracks-therapeutic-response-in-traumatic-brain-injury
#7
Damon Christopher Barbacci, Aurélie Roux, Ludovic Muller, Shelley N Jackson, Jeremy Post, Kathrine Baldwin, Barry Hoffer, Carey Balaban, Shawn Gouty, Brian M Cox, Amina S Woods
Traumatic brain injury (TBI) is a serious public health problem and the leading cause of death in children and young adults. It also contributes to a substantial number of cases of permanent disability. As lipids make up over 50% of the brain mass and play a key role in both membrane structure and cell signaling, their profile is of particular interest. In this study, we show that advanced mass spectrometry imaging (MSI) has sufficient technical accuracy and reproducibility to demonstrate the anatomical distribution of 50 micron diameter microdomains that show changes in brain ceramide levels in a rat model of controlled cortical impact (CCI) 3 days post injury with and without treatment...
July 26, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28745856/severe-traumatic-brain-injury-in-children-an-evidence-based-review-of-emergency-department-management-digest
#8
Kirsten Morrissey, Hilary Fairbrother, Michelle N Vazquez
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 22, 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28744846/extubation-failure-and-tracheostomy-placement-in-children-with-acute-neurocritical-illness
#9
Ellen C Cohn, Tammy S Robertson, Stacey A Scott, Andre M Finley, Rong Huang, Darryl K Miles
BACKGROUND: There is a lack of data describing the risk factors for extubation failure (EF) or tracheostomy placement in pediatric neurocritical care (NCC) patients. METHODS: A retrospective chart review of children admitted to the pediatric intensive care unit who were intubated for >24 h with an acute neurocritical illness and had an extubation attempt. Bivariate and multivariate statistical analysis was performed to determine significant associations of demographic, neurologic, pulmonary, and clinical variables with EF and tracheostomy placement...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28738850/brain-biomarkers-and-pre-injury-cognition-are-associated-with-long-term-cognitive-outcome-in-children-with-traumatic-brain-injury
#10
Amy A Wilkinson, Maureen Dennis, Nevena Simic, Margot J Taylor, Benjamin R Morgan, Helena Frndova, Karen Choong, Craig Campbell, Douglas Fraser, Vicki Anderson, Anne-Marie Guerguerian, Russell Schachar, Jamie Hutchison
BACKGROUND: Children with traumatic brain injury (TBI) are frequently at risk of long-term impairments of attention and executive functioning but these problems are difficult to predict. Although deficits have been reported to vary with injury severity, age at injury and sex, prognostication of outcome remains imperfect at a patient-specific level. The objective of this proof of principle study was to evaluate a variety of patient variables, along with six brain-specific and inflammatory serum protein biomarkers, as predictors of long-term cognitive outcome following paediatric TBI...
July 24, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28724466/home-environment-as-a-predictor-of-long-term-executive-functioning-following-early-childhood-traumatic-brain-injury
#11
Christianne Laliberté Durish, Keith Owen Yeates, Terry Stancin, H Gerry Taylor, Nicolay C Walz, Shari L Wade
OBJECTIVES: This study examined the relationship of the home environment to long-term executive functioning (EF) following early childhood traumatic brain injury (TBI). METHODS: Participants (N=134) were drawn from a larger parent study of 3- to 6-year-old children hospitalized for severe TBI (n=16), complicated mild/moderate TBI (n=44), or orthopedic injury (OI; n=74), recruited prospectively at four tertiary care hospitals in the United States and followed for an average of 6...
July 20, 2017: Journal of the International Neuropsychological Society: JINS
https://www.readbyqxmd.com/read/28710227/advancing-concussion-assessment-in-pediatrics-a-cap-a-prospective-concurrent-cohort-longitudinal-study-of-mild-traumatic-brain-injury-in-children-protocol-study
#12
Keith Owen Yeates, Miriam Beauchamp, William Craig, Quynh Doan, Roger Zemek, Bruce Bjornson, Jocelyn Gravel, Angelo Mikrogianakis, Bradley Goodyear, Nishard Abdeen, Christian Beaulieu, Mathieu Dehaes, Sylvain Deschenes, Ashley Harris, Catherine Lebel, Ryan Lamont, Tyler Williamson, Karen Maria Barlow, Francois Bernier, Brian L Brooks, Carolyn Emery, Stephen B Freedman, Kristina Kowalski, Kelly Mrklas, Lianne Tomfohr-Madsen, Kathryn J Schneider
INTRODUCTION: Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28700591/trends-in-traumatic-brain-injury-mortality-in-china-2006-2013-a-population-based-longitudinal-study
#13
Peixia Cheng, Peng Yin, Peishan Ning, Lijun Wang, Xunjie Cheng, Yunning Liu, David C Schwebel, Jiangmei Liu, Jinlei Qi, Guoqing Hu, Maigeng Zhou
BACKGROUND: Traumatic brain injury (TBI) is a significant global public health problem, but has received minimal attention from researchers and policy-makers in low- and middle-income countries (LMICs). Epidemiological evidence of TBI morbidity and mortality is absent at the national level for most LMICs, including China. Using data from China's Disease Surveillance Points (DSPs) system, we conducted a population-based longitudinal analysis to examine TBI mortality, and mortality differences by sex, age group, location (urban/rural), and external cause of injury, from 1 January 2006 to 31 December 2013 in China...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28692408/preliminary-findings-of-altered-functional-connectivity-of-the-default-mode-network-linked-to-functional-outcomes-one-year-after-pediatric-traumatic-brain-injury
#14
Jaclyn A Stephens, Cynthia F Salorio, Anita D Barber, Sarah R Risen, Stewart H Mostofsky, Stacy J Suskauer
PURPOSE AND METHOD: This study examined functional connectivity of the default mode network (DMN) and examined brain-behavior relationships in a pilot cohort of children with chronic mild to moderate traumatic brain injury (TBI). RESULTS: Compared to uninjured peers, children with TBI demonstrated less anti-correlated functional connectivity between DMN and right Brodmann Area 40 (BA 40). In children with TBI, more anomalous less anti-correlated) connectivity between DMN and right BA 40 was linked to poorer performance on response inhibition tasks...
July 10, 2017: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/28692352/responsiveness-and-discriminant-validity-of-the-child-and-adolescent-scale-of-participation-across-three-years-for-children-and-youth-with-traumatic-brain-injury
#15
Anat Golos, Gary Bedell
PURPOSE: To examine responsiveness and discriminant validity of the Child and Adolescent Scale of Participation (CASP) across three years. METHODS: Examined longitudinal data on 515 children and youth with TBI and arm injuries. Repeated measures analyses of variance were used to examine CASP scores (pre-injury; 3, 12, 24, 36 months post-injury). RESULTS: Scores decreased from pre-injury to 3 months, but significantly only for moderate and severe TBI groups...
July 10, 2017: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/28686657/phase-i-randomized-clinical-trial-of-n-acetylcysteine-in-combination-with-an-adjuvant-probenecid-for-treatment-of-severe-traumatic-brain-injury-in-children
#16
Robert S B Clark, Philip E Empey, Hülya Bayır, Bedda L Rosario, Samuel M Poloyac, Patrick M Kochanek, Thomas D Nolin, Alicia K Au, Christopher M Horvat, Stephen R Wisniewski, Michael J Bell
BACKGROUND: There are no therapies shown to improve outcome after severe traumatic brain injury (TBI) in humans, a leading cause of morbidity and mortality. We sought to verify brain exposure of the systemically administered antioxidant N-acetylcysteine (NAC) and the synergistic adjuvant probenecid, and identify adverse effects of this drug combination after severe TBI in children. METHODS: IRB-approved, randomized, double-blind, placebo controlled Phase I study in children 2 to 18 years-of-age admitted to a Pediatric Intensive Care Unit after severe TBI (Glasgow Coma Scale [GCS] score ≤8) requiring an externalized ventricular drain for measurement of intracranial pressure (ICP)...
2017: PloS One
https://www.readbyqxmd.com/read/28685977/the-post-therapeutic-effect-of-rapamycin-in-mild-traumatic-brain-injured-rats-ensuing-in-the-upregulation-of-autophagy-and-mitophagy
#17
Changxing Wang, Zhiying Hu, Yang Zou, Mingjun Xiang, Yuting Jiang, Benson O A Botchway, Xue Huo, Xiaoxue Du, Marong Fang
Mild traumatic brain injury (mTBI), common in juveniles, has been reported to be caused by sports-related concussion. Many young children may suffer from post-concussion syndrome. mTBI, in early stages of life, could play a part in neuron apoptosis and degeneration, cognitive and motor coordination impairment, as well as dementia. Our study was aimed at further investigating the post-therapeutic efficacy of rapamycin in the recuperation of mTBI while at the same time investigating the metamorphosis in both autophagy and mitophagy in mTBI...
September 2017: Cell Biology International
https://www.readbyqxmd.com/read/28667938/altered-stress-system-reactivity-after-pediatric-injury-relation-with-post-traumatic-stress-symptoms
#18
Linda Ewing-Cobbs, Mary R Prasad, Charles S Cox, Douglas A Granger, Gerardo Duque, Paul R Swank
Injury is the leading cause of death and disability in childhood. Injured children are at high risk for developing alterations in stress response systems and post-traumatic stress symptoms (PTSS) that may compromise long-term physical and psychological health. In a prospective, observational cohort study, we examined individual differences in, and correlates of, stress-reactivity of the hypothalamic-pituitary-adrenal axis (HPA; salivary cortisol) and autonomic nervous system (ANS; salivary alpha amylase, sAA) following pediatric injury...
October 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28659005/preinjury-characteristics-of-children-with-mild-traumatic-brain-injury-is-other-injury-an-appropriate-comparison-group
#19
A McKinlay, M Albicini, M Than
BACKGROUND: Mild traumatic brain injury (mTBI) has been associated with ongoing problems in children and young people. However, there remains to be considerable debate regarding whether outcomes are a result of brain impairment, or simply reflect preinjury characteristics of the child or family. To reliably assess outcomes, an appropriate control group is required. AIMS: This study aimed to identify the preinjury characteristics of children with mTBI, and to examine whether an "other injury to the head" group is an appropriate comparison to control for preinjury characteristics of children with mTBI...
June 29, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/28657644/communication-in-children-and-adolescents-after-acquired-brain-injury-an-exploratory-study
#20
Åsa Fyrberg, Göran Horneman, Jakob Åsberg Johnels, Gunilla Thunberg, Elisabeth Ahlsén
OBJECTIVE: The usability of the Communicative Effectiveness Index (CETI) in adolescents with acquired brain injury was investigated and compared with linguistic, cognitive and brain injury data. DESIGN: A prospective, longitudinal, between-group design. SUBJECTS: Thirty participants were divided into 2 subgroups: CETI+ and CETI- groups. METHODS: Parental CETI ratings of daily communication were compared with linguistic data and IQ test results...
June 28, 2017: Journal of Rehabilitation Medicine
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