The ABCs of Pediatric Head Trauma

Catherine A. Mazzola; P. David Adelson

doi:10.1055/s-2002-35245

Seminars in Neurosurgery, Table of Contents

Seminars in Neurosurgery 2002; 13(1): 029-038
DOI: 10.1055/s-2002-35245

The ABCs of Pediatric Head Trauma

Catherine A. Mazzola, P. David Adelson

Department of Neurosurgery, University of Pittsburgh, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania

Abstract

ABSTRACT

Traumatic injury is the leading cause of morbidity and mortality in children, and causes over half of all childhood deaths.[1] [2] [3] [4] Mortality rates of 30 to 50% have been reported for children with traumatic brain injury (TBI). Although children have better survival rates than adults, the long-term sequelae are more devastating in children due to their age and extended life expectancy.[5] Costs involved in care of a child with head injury, extended over the lifetime of the patient, are tremendous. It is unfortunate that despite preventive measures, TBI remains the major morbidity and mortality factor for children.

KEYWORDS

Brain injury - diffuse axonal injury - intracranial pressure - pediatric - shaken baby - trauma

Full Text

References

REFERENCES

1 Aldrich E F, Eisenberg H M, Saydjari C. Diffuse brain swelling in severely head injured children: a report from the NIH Traumatic Coma Data Bank. J Neurosurg . 1992; 76 450-454
2 Hoyert D L, Freedman M A, Strobino D M, Guyer B. Annual summary of vital statistics. Pediatrics . 2001; 108 1241-1255
3 Luerssen T G, Klauber M R, Marshall L F. Outcome from head injury related to patient's age. J Neurosurg . 1988; 68 409-416
4 Wegman W E. Annual summary of vital statistics-1981. Pediatrics . 1981; 75 835-843
5 Shewmon D A. Coma prognosis in children. J Clin Neurophys . 2000; 17 467-472
6 Childhood injuries in the United States. Division of Injury Control, Center for Environmental Health and Injury Control, Centers for Disease Control. Am J Dis Child . 1990; 144 627-647
7 Kraus J F, Rock A, Hemyari P. Brain injuries among infants. Am J Dis Child . 1990; 144 684-691
8 Rivara F P. Childhood injuries. Dev Med Child Neurol . 1984; 26 81-87
9 Greenes D S, Schutzman S A. Clinical indicators of intracranial injury in head injured infants. Pediatrics . 1999; 104 861-867
10 Quayle K S, Jaffe D M, Kuppermann N. Diagnostic testing for acute head injury in children. Pediatrics . 1997; 99 E11
11 Levin H S, Aldrich E F, Saydjari C. Severe head injury in children. Neurosurgery . 1992; 31 435-444
12 Forbes M T, Hendrich K S, Schiding J K. Perfusion-weighted MRI assessment of cerebral blood flow and CO₂ reactivity after controlled cortical impact in rats (abstract). J Neurotrauma . 1995; 12 988
13 Orliaguet G, Lejay M. Pediatric trauma patients. Current Opinion in Critical Care . 1999; 5 506-510
14 Graham D I, Ford I, Adams J H. Fatal head injury in children. J Clin Pathol . 1988; 42 18-22
15 Graham D I, Lawrence A E, Adams J H. Brain damage in fatal nonmissile head injury without high intracranial pressure. J Clin Pathol . 1988; 41 34-37
16 Adelson P D, Clyde B, Kochanek P M. Cerebrovascular response in infants and young children following severe traumatic brain injury. Pediatr Neurosurg . 1997; 26 200-207
17 Ruppel R A, Kochanek P M, Adelson P D. Excitatory amino acid concentrations in ventricular cerebrospinal fluid after severe traumatic brain injury in infants and children. J of Pediatrics . 2001; 138 18-25
18 Choi D W, Maulucci-Gedde M, Kriegstein A R. Glutamate neurotoxicity in cortical cell culture. J Neurosci . 1987; 7 357-368
19 McDonald J W, Silverstein F S, Johnston M V. Neurotoxicity of N-methyl-D-aspartate is markedly enhanced in developing rat central nervous system. Brain Res . 1988; 459 200-203
20 Fineman I, Hovda D A, Smith M. Concussive brain injury is associated with a prolonged accumulation of calcium: a 45Ca autoradiographic study. Brain Res . 1993; 624 94-102
21 Bittigau P, Sifringer M, Pohl D. Apoptotic neurodegeneration following trauma is markedly enhanced in the immature brain. Ann of Neurol . 1999; 45 724-735
22 Schutzman S A, Greenes D S. Pediatric minor head trauma. Annals of Emerg Med . 2001; 37 65-74
23 Michaud L J, Rivara F P, Grady M S, Reay D T. Predictors of survival and severity of disability after severe head injury in children. Neurosurgery . 1991; 31 254-264
24 Levi L, Guilburd J N, Linn S. The association between skull fracture, intracranial pathology and outcome in pediatric head injury. Br J Neurosurg . 1991; 5 617-625
25 Keskil I S, Baykaner M K, Ceviker N. Assessment of mortality associated with mild head injury in the pediatric age group. Childs Nerv Syst . 1995; 11 467-473
26 Wang M Y, Griffith P, Sterling J. A prospective population based study of pediatric trauma patients with mild alterations of consciousness (GCS 13-14). Neurosurgery . 2000; 46 1093-1099
27 Rosenthal B W, Bergman I. Intracranial injury after moderate head trauma in children. J Pediatr . 1989; 115 346-350
28 Schunk J E, Rodgerson J D, Woodward G A. The utility of head computed tomographic scanning in pediatric patients with normal neurologic examination in the emergency department. Pediat Emerg Care . 1996; 12 160-165
29 Simon B, Letourneau P, Vitorino E. Pediatric minor head trauma: indications for CT scanning revisited. J Trauma . 2001; 51 231-238
30 Bergsneider M, Hovda D A, AcArthur D L. Metabolic recovery following human traumatic brain injury based on FDG-PET: time course and relationship to neurological disability. J Head Trauma Rehabil . 2001; 16 135-148
31 Suh D Y, Davis P C, Hopkins K L. Nonaccidental pediatric head injury: diffusion weighted imaging findings. Neurosurgery . 2001; 49 309-319
32 Brooks W M, Friedman S D, Gaspoarovic C. Magnetic resonance spectroscopy in traumatic brain injury. J of Head Trauma Rehab . 2001; 16 149-164
33 Beca J, Cox P N, Taylor M J. Somatosensory evoked potentials for prediction of outcome in acute severe brain injury. J Pediatr . 1995; 126 44-49
34 Hulihan J F, Syna D R. Electroencephalographic sleep patterns in post-anoxic stupor and coma. Neurology . 1994; 44 758-760
35 Pampigliona G, Chaloner J, Harden A. Transitory ischemia/anoxia in young children and the prediction of quality of survival. Ann N Y Acad Sci . 1978; 315 281-292
36 White L E, Frank L M, Furgiuele T L. Childhood coma: improved prediction of outcome with somatosensory and brainstem auditory evoked potentials (abstract). Ann Neurol . 1985; 18 417
37 Marshall L F. Head injury: recent past, present and future. Neurosurgery . 2000; 47 546-561
38 Feldman Z, Kanter M J, Robertson M J. Effect of head elevation on intracranial pressure, cerebral perfusion, and cerebral blood flow in head injured patients. J Neurosurg . 1992; 76 207-211
39 Bruce D A, Raphaely R C, Goldberg A I. Pathophysiology, treatment, and outcome following severe head injury in children. Child's Brain . 1979; 5 174-191
40 Mirski M A, Denchev D I, Schnitzer M S. Comparison between hypertonic saline and mannitol in the reduction of elevated intracranial pressure in a rodent model of acute cerebral injury. J of Neurosurg Anesthes . 2000; 12 334-344
41 Muizelaar J P, van der Poel G H, Li Z C. Pial arteriolar vessel diameter and CO₂ reactivity during prolonged hyperventilation in the rabbit. J Neurosurg . 1988; 69 923-927
42 Temkin N R, Dikmen S S, Wilensky A J. A randomized, double-blind study of phenytoin for the prevention of posttraumatic seizures. N Engl J Med . 1990; 323 497-502
43 Temkin N R, Dikmen S S, Winn H R. Posttraumatic seizures. Neurosurg Clin North Am . 1991; 2 425-435
44 Douzinas E E, Pitaridis M T, Louris G. Prevention of infection in multiple trauma patients by high-dose intravenous immunoglobulins. Crit Care Med . 2000; 28 8-15
45 Hendrick E B. The use of hypothermia in severe head injuries in childhood. Arch Surg . 1959; 79 362-364
46 Lazorthes G, Capman L. Hypothermia in the treatment of craniocerebral traumatism. J Neurosurg . 1958; 15 162-167
47 Sedzmir C B. Therapeutic hypothermia in cases of head injury. J Neurosurg . 1959; 16 407-414
48 Guyer B, Ellers B. Childhood injuries in the United States. Am J Dis Child . 1990; 144 649-652
49 Boyer M G, Edwards P. Outcome 1 to 3 years after severe traumatic brain injury in children and adolescents. Injury . 1999; 22 315-320
50 Brink J D, Garrett A L, Hale W R. Recovery of motor and intellectual function in children sustaining severe head injuries. Develop Med Child Neurol . 1970; 12 565-571
51 Koskiniemi M, Kyykka T, Nybo T. Long-term outcome after severe brain injury in preschoolers is worse than expected. Arch Pediatr Adolesc Med . 1995; 149 249-254
52 Mahoney W J, D'Souza B J, Haller A. Long-term outcome of children with severe head trauma and prolonged coma. Pediatrics . 1983; 71 756-762
53 Tilford J M, Simpson P M, Yeh T S. Variation in therapy and outcome for pediatric head trauma patients. Crit Care Med . 2001; 29 1056-1061
54 Annegers J F, Grabow J D, Kurland K T. The incidence, causes, and secular trends of head injury in Olmstead County, Minnesota, 1935-1994. Neurology . 1980; 30 912-919
55 Gross C R, Wolf C, Kunitz S C. Pilot Traumatic Coma Data Bank. In: Dacey RG Jr, Winn HR, Rimel RW, Jane JA, eds. Trauma of the Central Nervous System New York: Raven Press 1985: 19-26
56 Van der Sluis K C, Kingma J, Eisma W H. Pediatric polytrauma: short- and long-term outcomes. J Trauma . 1997; 43 501-506
57 Functional Independence Measure. Guide for the Uniform Data Set for Medical Rehabilitation, Version 4.0 Buffalo, NY: SUNY at Buffalo 1993
58 Jennett B, Bond M. Assessment of outcome after severe brain damage: a practical scale. Lancet . 1975; 1 480
59 Ewing-Cobbs L, Kramer L, Prasad M. Neuroimaging, physical, and developmental findings after inflicted and noninflicted traumatic brain injury in young children. Pediatrics . 1998; 102 300-307
60 Bawden H N, Knights R M, Winogrom H W. Speeded performance following head injury in children. J Clin Exp Neuropsychol . 1997; 7 39-54
61 Kaufmann P M, Fletcher J M, Levin H S. Attention disturbance after pediatric closed head injury. J Child Neurol . 1993; 8 348-353
62 Klonoff H, Low M D, Clark C. Head injuries in children. J Neurol Neurosurg Psych . 1977; 40 1211-1219
63 Levin H S, Culhane K A, Flethcher J M. Dissociation between delayed alternation and memory after pediatric head injury. J Child Neurol . 1994; 9 81-89
64 Winogron H W, Knights R M, Bawden H N. Neuropsychological deficits following head injury in children. J Clin Neuropsychol . 1984; 6 269-286
65 Hotz G, Helm-Estabrooks N, Nelson N W. Development of the Pediatric Test of Brain Injury. J of Head Trauma Rehab . 2001; 16 426-440
66 Mittenberg W, Strauman S. Diagnosis of mild head injury and the postconcussion syndrome. J of Head Trauma Rehab . 2000; 15 783-791
67 Donders J, Strom D. Neurobehavioral recovery after pediatric head trauma. J of Head Trauma Rehab . 2000; 15 792-803
68 Collins M, Grindel S, Lovell M. A relationship between concussion and neuropsychological performance in college football players. JAMA . 1999; 282 964-970
69 Master E, Kessels A, Lezak M. Neuropsychological impairment in amateur soccer players. JAMA . 1999; 282 971-973
70 Anderson V, Morse S, Klug G. Predicting recovery from head injury in young children. J Int Neuropsych Soc . 1997; 3 581-591
71 Jenny C, Hymel K P, Ritzen A. Analysis of missed cases of abusive head trauma. JAMA . 1999; 281 621-626
72 Hahn Y S, Raimondi A J, McLone D G. Traumatic mechanisms of head injury in child abuse. Childs Brain . 1983; 10 229-241
73 Reece R M, Sege R. Childhood head injuries: accidental or inflicted?. Arch of Ped & Adol Med . 2000; 154 11-15
74 Becker H, Gupta B. Recognizing abusive head trauma in children. JAMA . 1999; 282 1421-1422