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Traumatic brain injury in children

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https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#1
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28429381/the-structural-connectome-of-children-with-traumatic-brain-injury
#2
Marsh Königs, L W Ernest van Heurn, Roel Bakx, R Jeroen Vermeulen, J Carel Goslings, Bwee Tien Poll-The, Marleen van der Wees, Coriene E Catsman-Berrevoets, Jaap Oosterlaan, Petra J W Pouwels
This study aimed to investigate the impact of mild to severe pediatric TBI on the structural connectome. Children aged 8-14 years with trauma control (TC) injury (n = 27) were compared to children with mild TBI and risk factors for complicated TBI (mild(RF+) , n = 20) or moderate/severe TBI (n = 16) at 2.8 years post-injury. Probabilistic tractography on diffusion tensor imaging data was used in combination with graph theory to study structural connectivity. Functional outcome was measured using neurocognitive tests and parent and teacher questionnaires for behavioral functioning...
April 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28425334/remifentanil-for-sedation-of-children-with-traumatic-brain-injury
#3
James L Hungerford, Nicole O'Brien, Melissa Moore-Clingenpeel, Eric A Sribnick, Cheryl Sargel, Mark Hall, Jeffrey R Leonard, Joseph D Tobias
OBJECTIVE: To determine whether remifentanil would provide adequate sedation while allowing frequent and reproducible neurologic assessments in children admitted to the pediatric intensive care unit (PICU) with traumatic brain injury (TBI) during mechanical ventilation. DESIGN: Retrospective review. SETTING: Tertiary care PICU. PATIENTS: Thirty-eight patients over a 30-month period. MEASUREMENTS AND MAIN RESULTS: Median age was 9 years (interquartile range [IQR] 2...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28422896/predictors-of-sleep-outcomes-following-mild-traumatic-brain-injury-in-preschoolers-subjective-and-objective-assessment-of-outcome
#4
Catherine Landry-Roy, Annie Bernier, Jocelyn Gravel, Miriam H Beauchamp
OBJECTIVES: To investigate sleep and its predictors in preschoolers with mild traumatic brain injury (mTBI). PARTICIPANTS AND PROCEDURE: The sample included 225 children, aged 18 to 60 months, divided into 3 groups: children with accidental mTBI (n = 85), children with orthopedic injury (n = 58), and typically developing children (n = 82). Retrospective reports of preinjury sleep and family functioning were obtained as part of a baseline assessment at the time of recruitment...
April 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28422893/do-concussive-symptoms-really-resolve-in-young-children
#5
Coco O Bernard, Jennie L Ponsford, Audrey McKinlay, Dean McKenzie, David Krieser
OBJECTIVES: To examine the frequency and nature of postconcussive symptoms (PCSs) and behavioral outcomes in young children following mild traumatic brain injury (mTBI) or concussion. SETTING: Emergency department. PARTICIPANTS: Children aged 2 to 12 years presenting with either a concussion or minor bodily injury (control). OUTCOME MEASUREMENT: Parent ratings of PCS were obtained within 72 hours of injury, at 1 week, and 1, 2, and 3 months postinjury using a comprehensive PCS checklist...
April 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#6
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28407334/time-to-cranial-computerised-tomography-for-acute-traumatic-brain-injury-in-paediatric-patients-effect-of-the-shorter-stays-in-emergency-departments-target-in-new-zealand
#7
Peter G Jones, Bridget Kool, Stuart Dalziel, Michael Shepherd, James Le Fevre, Alana Harper, Susan Wells, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: Timely access to computerised tomography (CT) for acute traumatic brain injuries (TBIs) facilitates rapid diagnosis and surgical intervention. In 2009, New Zealand introduced a mandatory target for emergency department (ED) stay such that 95% of patients should leave ED within 6 h of arrival. This study investigated whether this target influenced the timeliness of cranial CT scanning in children who presented to ED with acute TBI. METHODS: We retrospectively reviewed a random sample of charts of children <15 years with acute TBI from 2006 to 2012...
April 13, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28406438/u-s-trends-of-ed-visits-for-pediatric-traumatic-brain-injuries-implications-for-clinical-trials
#8
Cheng Chen, Junxin Shi, Rachel M Stanley, Eric A Sribnick, Jonathan I Groner, Henry Xiang
Our goal in this paper was to use the 2006-2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of annual patient number, patient demographics and hospital characteristics of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments (EDs); and to use the same database to estimate the available sample sizes for various clinical trials of pediatric TBI cases. National estimates of patient demographics and hospital characteristics were calculated for pediatric TBI...
April 13, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28405773/failure-and-fatigue-properties-of-immature-human-and-porcine-parasagittal-bridging-veins
#9
Stephanie A Pasquesi, Susan S Margulies
Tearing of the parasagittal bridging veins (BVs) is thought to be a source of extra-axial hemorrhage (EAH) associated with abusive traumatic brain injuries (TBIs) in children. However, the pediatric BV mechanical properties are unknown. We subjected porcine adult, porcine newborn, and human infant BVs to either a low rate pull to failure, a high rate pull to failure, or 30 s of cyclic loading followed by a pull to failure. An additional subset of human infant BVs was examined for viscoelastic recovery between two cycling episodes...
April 12, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28398160/should-young-children-with-tbi-be-compared-to-community-or-orthopedic-control-participants
#10
Miriam Helen Beauchamp, Catherine Landry-Roy, Jocelyn Gravel, Cindy Beaudoin, Annie Bernier
Pediatric traumatic brain injury (TBI) research depends on comparisons of profiles and outcome between brain injured individuals and groups consisting either of injured controls (e.g., orthopedic injuries, OI) or uninjured, typically developing children recruited from the community (community controls, CC). Children with OI are thought to provide optimal comparisons for individuals with TBI because they share injury-related experiences and pre-morbid characteristics; however, a study by Mathias and colleagues (2013) in adults has called into question the added value of injury control groups in TBI research...
April 11, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28397372/k-channel-impairment-determines-sex-and-age-differences-in-epinephrine-mediated-outcomes-after-brain-injury
#11
William M Armstead, John Riley, Monica S Vavilala
Traumatic brain injury (TBI) is the leading cause of injury-related death in children, with boys and children under 4 years having particularly poor outcomes. Activation of ATP- and calcium-sensitive (KATP and KCa ) channels produces cerebrovasodilation and contributes to autoregulation, both of which are impaired after TBI, contributing to poor outcomes. Upregulation of the c-Jun-terminal kinase (JNK) isoform of mitogen-activated protein kinase produces K channel function impairment after CNS injury. Vasoactive agents can be used to normalize cerebral perfusion pressure...
April 11, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28389109/problem-solving-following-traumatic-brain-injury-in-adolescence-associations-with-functional-outcomes
#12
Shari L Wade, Amy E Cassedy, Lauren E Fulks, H Gerry Taylor, Terry Stancin, Michael W Kirkwood, Keith O Yeates, Brad G Kurowski
OBJECTIVE: To examine the association of problem solving with functioning in youth with traumatic brain injury (TBI). DESIGN: Cross-sectional evaluation of pre-treatment data from a randomized clinical trial. SETTING: Four children's hospitals and one general hospital, with level 1 trauma units. PARTICIPANTS: Youth, ages 11 to 18, who sustained moderate or severe TBI in the past 18 months (n = 133). MAIN OUTCOME AND MEASURES: Problem-solving skills were assessed using the Social Problem Solving Inventory (SPSI) and the Dodge Social Information Processing Short Stories (SIP-SR)...
April 4, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28387644/medical-necessity-of-routine-admission-of-children-with-mild-traumatic-brain-injury-to-the-intensive-care-unit
#13
Jared D Ament, Krista N Greenan, Patrick Tertulien, Joseph M Galante, Daniel K Nishijima, Marike Zwienenberg
OBJECTIVE Approximately 475,000 children are treated for traumatic brain injury (TBI) in the US each year; most are classified as mild TBI (Glasgow Coma Scale [GCS] Score 13-15). Patients with positive findings on head CT, defined as either intracranial hemorrhage or skull fracture, regardless of severity, are often transferred to tertiary care centers for intensive care unit (ICU) monitoring. This practice creates a significant burden on the health care system. The purpose of this investigation was to derive a clinical decision rule (CDR) to determine which children can safely avoid ICU care...
April 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28377126/vascular-impairment-as-a-pathological-mechanism-underlying-long-lasting-cognitive-dysfunction-after-pediatric-traumatic-brain-injury
#14
Ichkova Aleksandra, Beatriz Rodriguez-Grande, Claire Bar, Frederic Villega, Jan Pieter Konsman, Jerome Badaut
Traumatic brain injury (TBI) is the leading cause of death and disability in children. Indeed, the acute mechanical injury often evolves to a chronic brain disorder with long-term cognitive, emotional and social dysfunction even in the case of mild TBI. Contrary to the commonly held idea that children show better recovery from injuries than adults, pediatric TBI patients actually have worse outcome than adults for the same degree of injury severity. Acute trauma to the young brain likely interferes with the fine-tuned developmental processes and may give rise to long-lasting consequences on brain's function...
April 1, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28369828/raised-intracranial-pressure-and-retinal-haemorrhages-in-childhood-encephalopathies
#15
Robert A Minns, Patricia A Jones, Anamika Tandon, Brian W Fleck, Alan O Mulvihill, Fiona C Minns
AIM: To explore the relationship between raised intracranial pressure (RICP) and retinal haemorrhages in traumatic and non-traumatic childhood encephalopathies. METHOD: A prospective study of 112 children (35 females and 77 males, age range 0.01mo-17y 8.3mo; mean 5y 8.6mo, median 4y 5.6mo) included 57 accidental traumatic brain injuries (ATBIs), 21 inflicted traumatic brain injuries (ITBIs), and 34 non-traumatic encephalopathy cases. Measurements included intracranial pressure (ICP), cerebral perfusion pressure, pressure-time index of ICP, and number, zone, and layer of retinal haemorrhages on retinal imaging...
March 29, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28368495/comprehensive-review-of-the-thinkfirst-injury-prevention-programs-a-30-year-success-story-for-organized-neurosurgery
#16
Emily H Youngers, Kayt Zundel, Deborah Gerhardstein, Mariela Martínez, Carlos Bertrán, Mark R Proctor, Mark A Spatola, Edward A Neuwelt
Traumatic brain and spinal cord injuries are major public health issues causing significant death and long-term disability in the United States, with higher incidences in young and older adults. The ThinkFirst National Injury Prevention Foundation is a nonprofit organization focused on injury prevention education and awareness for people of all ages, with a particular focus on educating children, teens, and young adults. ThinkFirst chapters have evaluated the effectiveness of the ThinkFirst programs in both children and teens by demonstrating significant improvement in knowledge regarding high-risk behaviors postintervention...
March 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28362667/implementation-strategies-in-pediatric-neurocritical-care
#17
Christopher Markham, Enola K Proctor, Jose A Pineda
PURPOSE OF REVIEW: Brain-directed critical care for children is a relatively new area of subspecialization in pediatric critical care. Pediatric neurocritical care teams combine the expertise of neurology, neurosurgery, and critical care medicine. The positive impact of delivering specialized care to pediatric patients with acute neurological illness is becoming more apparent, but the optimum way to implement and sustain the delivery of this is complicated and poorly understood. We aim to provide emerging evidence supporting that effective implementation of pediatric neurocritical care pathways can improve patient survival and outcomes...
March 30, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28355201/sex-and-age-differences-in-phenylephrine-mechanisms-and-outcomes-after-piglet-brain-injury
#18
Victor Curvello, Hugh Hekierski, John Riley, Monica Vavilala, William M Armstead
BACKGROUND: Traumatic brain injury (TBI) is the leading cause of injury related death in children, with boys and children under 4 having particularly poor outcomes. Cerebral autoregulation is often impaired after TBI, contributing to poor outcome. In prior studies of newborn pigs, phenylephrine (Phe) preferentially protected cerebral autoregulation in females but not males after TBI. We hypothesized that, in contrast to the newborn, Phe prevents impairment of autoregulation and tissue injury following TBI in both sexes of older pigs...
March 29, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28343321/a-risk-score-based-on-admission-characteristics-to-predict-progressive-hemorrhagic-injury-from-traumatic-brain-injury-in-children
#19
Guo-Wen Hu, Hai-Li Lang, Hua Guo, Lei Wu, Pei Zhang, Wei Kuang, Xin-Gen Zhu
Traumatic brain injury (TBI) is one of the leading causes of death and disability in children, and progressive hemorrhagic injury (PHI) post TBI is associated with poor outcomes. Therefore, the objective of this study was to develop and validate a prognostic model that uses the information available at admission to determine the likelihood of PHI occurrence after TBI in children. The identified demographic data, cause of injury, clinical predictors on admission, computed tomography scan characteristics, and routine laboratory parameters were collected and used to develop a PHI prognostic model with logistic regression analysis, and the prediction model was validated in 68 children...
March 25, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28341799/use-of-traumatic-brain-injury-prediction-rules-with-clinical-decision-support
#20
Peter S Dayan, Dustin W Ballard, Eric Tham, Jeff M Hoffman, Marguerite Swietlik, Sara J Deakyne, Evaline A Alessandrini, Leah Tzimenatos, Lalit Bajaj, David R Vinson, Dustin G Mark, Steve R Offerman, Uli K Chettipally, Marilyn D Paterno, Molly H Schaeffer, Jun Wang, T Charles Casper, Howard S Goldberg, Robert W Grundmeier, Nathan Kuppermann
OBJECTIVES: We determined whether implementing the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prediction rules and providing risks of clinically important TBIs (ciTBIs) with computerized clinical decision support (CDS) reduces computed tomography (CT) use for children with minor head trauma. METHODS: Nonrandomized trial with concurrent controls at 5 pediatric emergency departments (PEDs) and 8 general EDs (GEDs) between November 2011 and June 2014...
March 24, 2017: Pediatrics
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