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Traumatic brain injury in children

Anthony R Mawson, Nola T Radford, Binu Jacob
Stuttering affects about 1% of the general population and from 8 to 11% of children. The onset of persistent developmental stuttering (PDS) typically occurs between 2 and 4 years of age. The etiology of stuttering is unknown and a unifying hypothesis is lacking as of now. Clues to the pathogenesis of stuttering include the following observations: PDS is associated with adverse perinatal outcomes and birth-associated trauma; stuttering can recur or develop in adulthood following traumatic events such as brain injury and stroke; PDS is associated with structural and functional abnormalities in the brain associated with speech and language; and stuttering resolves spontaneously in a high percentage of affected children...
October 18, 2016: European Neurology
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
Sarit Shimony-Kanat, Julie Benbenishty
OBJECTIVE: To characterize trauma-related falls in infants and toddlers aged 0 to 3 years over a 4-year period and develop a risk stratification model of causes of fall injuries. METHODS: Data on falls of 0 to 3 year olds from 2009 to 2012 were identified from a Jerusalem tertiary hospital trauma registry (N = 422) and the National Trauma Registry of Israel (N = 4,131). RESULTS: Almost half of falls occurred during the first year of life, and 57% of the children were Jewish...
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
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
Isabelle Cossette, Marie-Ève Gagné, Marie-Christine Ouellet, Philippe Fait, Isabelle Gagnon, Katia Sirois, Sophie Blanchet, Natalie Le Sage, Bradford J McFadyen
OBJECTIVE: To compare gait parameters between children in early adolescence (EA) with and without a mild traumatic brain injury (mTBI) during dual-task walking (DTW). METHODS: Children in EA with mTBI (n = 14; six girls) were compared to those without (n = 13; five girls) while walking in different combinations of obstacle avoidance and cognitive dual-tasks. Gait speed and fluidity and their related dual-task costs (DTC) were analysed along with foot clearance and proximity to the obstacle...
October 14, 2016: Brain Injury: [BI]
Volker Ressel, Ruth O'Gorman Tuura, Ianina Scheer, Hubertus J A van Hedel
BACKGROUND: Rehabilitation in children with acquired brain injury is a challenging endeavour. There is a large variability in motor recovery between patients, and a need to optimize therapies by exploiting cerebral plasticity and recovery mechanisms. This retrospective study aims to identify tract-based markers that could serve as predictors of functional outcome following rehabilitation. METHODS: Twenty-nine children with traumatic brain injury (n = 14) or stroke (n = 15) underwent a 3 T Magnetic Resonance Imaging (MRI) measurement, including Diffusion Tensor Imaging (DTI) between admission to the Hospital and onset of rehabilitation therapy at the Rehabilitation Centre...
October 12, 2016: Brain Imaging and Behavior
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
Angelina R A Pikstra, Zwany Metting, Johanna M Fock, Joukje van der Naalt
BACKGROUND: Annually 14.000 children with traumatic brain injury (TBI) are admitted to the Emergency Department (ED) in the Netherlands. Presentation varies and a specific entity comprises the juvenile head trauma syndrome (JHTS) with secondary deterioration after a mild trauma. As outcome of JHTS can be fatal, early recognition is essential. AIM: To outline the epidemiology and clinical features of JHTS, in comparison to paediatric mild TBI patients without JHTS...
September 23, 2016: European Journal of Paediatric Neurology: EJPN
Giancarlo Nicosia, Domenico Cicala, Giuseppe Mirone, Pietro Spennato, Vincenzo Trischitta, Claudio Ruggiero, Gianluigi Guarneri, Mario Muto, Giuseppe Cinalli
INTRODUCTION: Acute basilar artery occlusion (ABAO) is an infrequent but potentially fatal cause of strokes in both adults and children, and it is usually due to vertebral artery dissection (VAD). VAD has been found to be usually a consequence of traumatic vertebral artery injury. ABAO usually presents with symptoms of acute ischemic stroke (AIS) of the posterior circulation or transient ischemic attack (TIA). It may lead to death or long-term disability if not promptly recanalized. Basilar artery recanalization in children can be achieved safely and with excellent clinical outcome using endovascular thrombectomy with the new generation self-expanding and retrievable stents...
October 4, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Fabien D'Hondt, Maryse Lassonde, Fanny Thebault-Dagher, Annie Bernier, Jocelyn Gravel, Phetsamone Vannasing, Miriam H Beauchamp
Evidence suggests that social skills are affected by childhood mild traumatic brain injury (mTBI), but the neural and affective substrates of these difficulties are still underexplored. In particular, nothing is known about consequences on the perception of emotional facial expressions, despite its critical role in social interactions and the importance of the preschool period in the development of this ability. This study thus aimed to investigate the electrophysiological correlates of emotional facial expressions processing after early mTBI...
October 4, 2016: Cognitive, Affective & Behavioral Neuroscience
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
J Faber, E A Wilde, G Hanten, L Ewing-Cobbs, M E Aitken, R Yallampalli, M C MacLeod, S H Mullins, Z D Chu, X Li, J V Hunter, L Noble-Haeusslein, H S Levin
PRIMARY OBJECTIVE: The long-term effects of TBI on verbal fluency and related structures, as well as the relation between cognition and structural integrity, were evaluated. It was hypothesized that the group with TBI would evidence poorer performance on cognitive measures and a decrease in structural integrity. RESEARCH DESIGN: Between a paediatric group with TBI and a group of typically-developing children, the long-term effects of traumatic brain injury were investigated in relation to both structural integrity and cognition...
September 28, 2016: Brain Injury: [BI]
Kevin S Nye, Matthew I Converse, Mar Janna Dahl, Kurt H Albertine, Kenneth L Monson
Traumatic brain injury (TBI) is a devastating problem for people of all ages, but the nature of the response to such injury is often different in children than in adults. Cerebral vessel damage and dysfunction are common following TBI, but age-dependent, large-deformation vessel response has not been characterized. Our objective was to investigate the mechanical properties of cerebral arteries as a function of development. Sheep middle cerebral arteries from four age groups (fetal, newborn, juvenile, and adult) were subjected to biaxial loading around physiological conditions and then to failure in the axial direction...
September 27, 2016: Annals of Biomedical Engineering
Mathilde Chevignard, Leila Francillette, Hanna Toure, Dominique Brugel, Philippe Meyer, Anne Laurent Vannier, Marion Opatowski, Laurence Watier
OBJECTIVE: Childhood traumatic brain injury (TBI) is the first cause of death and acquired disability and it represents a major public health issue. Childhood severe TBI can lead to motor, cognitive, behavioural and social cognition deficits, which have consequences on academic achievement, social integration, participation and quality of life. Consequences may only appear after a delay, when the skills are supposed to be fully developed. The aim of this study was to prospectively assess academic outcome, health-related quality of life (HRQoL), amount of ongoing care and participation, following childhood severe traumatic brain injury (TBI) over 7-8years post-injury, in comparison with a matched uninjured control group...
September 2016: Annals of Physical and Rehabilitation Medicine
Mathilde Chevignard, Leila Francillette, Hanna Toure, Dominique Brugel, Philippe Meyer, Anne Laurent Vannier, Marion Opatowski, Laurence Watier
OBJECTIVE: Childhood traumatic brain injury (TBI) is a leading cause of death and lifelong acquired disability. The aim of this study was to prospectively study intellectual ability following childhood severe TBI over 7-8years post-injury, and factors influencing outcome and change over time. MATERIAL/PATIENTS AND METHODS: Children (0-15years) consecutively admitted in a single trauma center for severe non-inflicted TBI over a 3-year period were included in a prospective longitudinal study...
September 2016: Annals of Physical and Rehabilitation Medicine
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
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