Pediatric Head Trauma

Nicole Sharp; Kelly Tieves

doi:10.1055/s-0035-1554989

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care 2015; 04(01): 047-054
DOI: 10.1055/s-0035-1554989

Review Article

Georg Thieme Verlag KG Stuttgart · New York

Pediatric Head Trauma

Nicole Sharp

¹Department of Surgery, Children's Mercy Hospital and Clinics, Kansas City, Missouri, United States

,

Kelly Tieves

²Department of Pediatrics, Critical Care Medicine, Children's Mercy Hospital and Clinics, Kansas City, Missouri, United States

› Author Affiliations

Abstract

Traumatic brain injury (TBI) refers to a spectrum of brain injury that can result in significant morbidity and mortality in pediatric patients. Pediatric head trauma is distinct from adult TBI. The purpose of this review article is to discuss pediatric TBI and current treatment modalities available.

Keywords

pediatric - children - head trauma - concussion - traumatic brain injury

Full Text

References

References
1 Garcia-Rodriguez JA, Thomas RE. Office management of mild head injury in children and adolescents. Can Fam Physician 2014; 60 (6) 523-531 , e294–e303
2 Geyer K, Meller K, Kulpan C, Mowery BD. Traumatic brain injury in children: acute care management. Pediatr Nurs 2013; 39 (6) 283-289
3 Perman SM, Goyal M, Neumar RW, Topjian AA, Gaieski DF. Clinical applications of targeted temperature management. Chest 2014; 145 (2) 386-393
4 Adekoya N, Thurman DJ, White DD, Webb KW. Surveillance for traumatic brain injury deaths—United States, 1989-1998. MMWR Surveill Summ 2002; 51 (10) 1-14
5 Langlois JA, Rutland-Brown W, Thomas KE. The incidence of traumatic brain injury among children in the United States: differences by race. J Head Trauma Rehabil 2005; 20 (3) 229-238
6 Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil 2006; 21 (5) 375-378
7 Hu CF, Fan HC, Chang CF, Chen SJ. Current approaches to the treatment of head injury in children. Pediatr Neonatol 2013; 54 (2) 73-81
8 Andersson EE, Sejdhage R, Wage V. Mild traumatic brain injuries in children between 0-16 years of age: a survey of activities and places when an accident occurs. Dev Neurorehabil 2012; 15 (1) 26-30
9 Wing R, James C. Pediatric head injury and concussion. Emerg Med Clin North Am 2013; 31 (3) 653-675
10 Meehan III WP, Taylor AM, Proctor M. The pediatric athlete: younger athletes with sport-related concussion. Clin Sports Med 2011; 30 (1) 133-144 , x
11 Muizelaar JP, Marmarou A, DeSalles AA , et al. Cerebral blood flow and metabolism in severely head-injured children. Part 1: Relationship with GCS score, outcome, ICP, and PVI. J Neurosurg 1989; 71 (1) 63-71
12 Shapiro K, Marmarou A. Clinical applications of the pressure-volume index in treatment of pediatric head injuries. J Neurosurg 1982; 56 (6) 819-825
13 Bouma GJ, Muizelaar JP. Evaluation of regional cerebral blood flow in acute head injury by stable xenon-enhanced computerized tomography. Acta Neurochir Suppl (Wien) 1993; 59: 34-40
14 Bouma GJ, Muizelaar JP. Cerebral blood flow in severe clinical head injury. New Horiz 1995; 3 (3) 384-394
15 Bouma GJ, Muizelaar JP, Choi SC, Newlon PG, Young HF. Cerebral circulation and metabolism after severe traumatic brain injury: the elusive role of ischemia. J Neurosurg 1991; 75 (5) 685-693
16 Cold GE. Cerebral blood flow in the acute phase after head injury. Part 2: Correlation to intraventricular pressure (IVP), cerebral perfusion pressure (CPP), PaCO2, ventricular fluid lactate, lactate/pyruvate ratio and pH. Acta Anaesthesiol Scand 1981; 25 (4) 332-335
17 Jaggi JL, Obrist WD, Gennarelli TA, Langfitt TW. Relationship of early cerebral blood flow and metabolism to outcome in acute head injury. J Neurosurg 1990; 72 (2) 176-182
18 Cruz J, Jaggi JL, Hoffstad OJ. Cerebral blood flow, vascular resistance, and oxygen metabolism in acute brain trauma: redefining the role of cerebral perfusion pressure?. Crit Care Med 1995; 23 (8) 1412-1417
19 Lang EW, Lagopoulos J, Griffith J , et al. Cerebral vasomotor reactivity testing in head injury: the link between pressure and flow. J Neurol Neurosurg Psychiatry 2003; 74 (8) 1053-1059
20 Paulson OB, Strandgaard S, Edvinsson L. Cerebral autoregulation. Cerebrovasc Brain Metab Rev 1990; 2 (2) 161-192
21 Vavilala MS, Muangman S, Tontisirin N , et al. Impaired cerebral autoregulation and 6-month outcome in children with severe traumatic brain injury: preliminary findings. Dev Neurosci 2006; 28 (4-5) 348-353
22 Downard C, Hulka F, Mullins RJ , et al. Relationship of cerebral perfusion pressure and survival in pediatric brain-injured patients. J Trauma 2000; 49 (4) 654-658 , discussion 658–659
23 Choi DW. Excitotoxic cell death. J Neurobiol 1992; 23 (9) 1261-1276
24 Choi DW, Maulucci-Gedde M, Kriegstein AR. Glutamate neurotoxicity in cortical cell culture. J Neurosci 1987; 7 (2) 357-368
25 Guskiewicz KM, Register-Mihalik J, McCrory P , et al. Evidence-based approach to revising the SCAT2: introducing the SCAT3. Br J Sports Med 2013; 47 (5) 289-293
26 Giza CC, Kutcher JS, Ashwal S , et al. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013; 80 (24) 2250-2257
27 McCrory P, Meeuwisse W, Johnston K , et al. Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Br J Sports Med 2009; 43 (Suppl. 01) i76-i90
28 Keightley ML, Côté P, Rumney P , et al. Psychosocial consequences of mild traumatic brain injury in children: results of a systematic review by the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil 2014; 95 (3, Suppl): S192-S200
29 Hung R, Carroll LJ, Cancelliere C , et al. Systematic review of the clinical course, natural history, and prognosis for pediatric mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil 2014; 95 (3, Suppl): S174-S191
30 Teasdale G, Gentleman D. The description of ‘conscious level’: a case for the Glasgow Coma Scale. Scott Med J 1982; 27 (1) 7-9
31 Purcell LK ; Canadian Paediatric Society, Healthy Active Living and Sports Medicine Committee. Evaluation and management of children and adolescents with sports-related concussion. Paediatr Child Health (Oxford) 2012; 17 (1) 31-34
32 Bell MJ, Kochanek PM. Pediatric traumatic brain injury in 2012: the year with new guidelines and common data elements. Crit Care Clin 2013; 29 (2) 223-238
33 Figg RE, Stouffer CW, Vander Kolk WE, Connors RH. Clinical efficacy of serial computed tomographic scanning in pediatric severe traumatic brain injury. Pediatr Surg Int 2006; 22 (3) 215-218
34 Mellion SA, Bennett KS, Ellsworth GL , et al. High-dose barbiturates for refractory intracranial hypertension in children with severe traumatic brain injury. Pediatr Crit Care Med 2013; 14 (3) 239-247
35 Bin SS, Schutzman SA, Greenes DS. Validation of a clinical score to predict skull fracture in head-injured infants. Pediatr Emerg Care 2010; 26 (9) 633-639
36 Rathore MH. Do prophylactic antibiotics prevent meningitis after basilar skull fracture?. Pediatr Infect Dis J 1991; 10 (2) 87-88
37 Villalobos T, Arango C, Kubilis P, Rathore M. Antibiotic prophylaxis after basilar skull fractures: a meta-analysis. Clin Infect Dis 1998; 27 (2) 364-369
38 Ratilal BO, Costa J, Sampaio C, Pappamikail L. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Cochrane Database Syst Rev 2011; (8) CD004884
39 Timmons SD. An update on traumatic brain injuries. J Neurosurg Sci 2012; 56 (3) 191-202
40 Kochanek PM, Carney N, Adelson PD , et al; American Academy of Pediatrics-Section on Neurological Surgery; American Association of Neurological Surgeons/Congress of Neurological Surgeons; Child Neurology Society; European Society of Pediatric and Neonatal Intensive Care; Neurocritical Care Society; Pediatric Neurocritical Care Research Group; Society of Critical Care Medicine; Paediatric Intensive Care Society UK; Society for Neuroscience in Anesthesiology and Critical Care; World Federation of Pediatric Intensive and Critical Care Societies. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents—second edition. Pediatr Crit Care Med 2012; 13 (Suppl. 01) S1-S82
41 Johnson DL, Krishnamurthy S. Send severely head-injured children to a pediatric trauma center. Pediatr Neurosurg 1996; 25 (6) 309-314
42 Hulka F, Mullins RJ, Mann NC , et al. Influence of a statewide trauma system on pediatric hospitalization and outcome. J Trauma 1997; 42 (3) 514-519
43 Potoka DA, Schall LC, Gardner MJ, Stafford PW, Peitzman AB, Ford HR. Impact of pediatric trauma centers on mortality in a statewide system. J Trauma 2000; 49 (2) 237-245
44 Cicero MX, Cross KP. Predictive value of initial Glasgow coma scale score in pediatric trauma patients. Pediatr Emerg Care 2013; 29 (1) 43-48
45 Dunning J, Daly JP, Lomas JP, Lecky F, Batchelor J, Mackway-Jones K ; Children's head injury algorithm for the prediction of important clinical events study group. Derivation of the children's head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child 2006; 91 (11) 885-891
46 Osmond MH, Klassen TP, Wells GA , et al; Pediatric Emergency Research Canada (PERC) Head Injury Study Group. CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. CMAJ 2010; 182 (4) 341-348
47 Kuppermann N, Holmes JF, Dayan PS , et al; Pediatric Emergency Care Applied Research Network (PECARN). Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 2009; 374 (9696) 1160-1170
48 Goske MJ, Applegate KE, Boylan J , et al. The ‘Image Gently’ campaign: increasing CT radiation dose awareness through a national education and awareness program. Pediatr Radiol 2008; 38 (3) 265-269
49 The ALARA. The ALARA (as low as reasonably achievable) concept in pediatric CT intelligent dose reduction. Multidisciplinary conference organized by the Society of Pediatric Radiology. August 18-19, 2001. Pediatr Radiol 2002; 32 (4) 217-313
50 Slovis TL. Children, computed tomography radiation dose, and the As Low As Reasonably Achievable (ALARA) concept. Pediatrics 2003; 112 (4) 971-972
51 Slovis TL. The ALARA concept in pediatric CT: myth or reality?. Radiology 2002; 223 (1) 5-6
52 Stocchetti N, Maas AI. Traumatic intracranial hypertension. N Engl J Med 2014; 370 (22) 2121-2130
53 Ropper AH. Hyperosmolar therapy for raised intracranial pressure. N Engl J Med 2012; 367 (8) 746-752
54 Kamel H, Navi BB, Nakagawa K, Hemphill III JC, Ko NU. Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta-analysis of randomized clinical trials. Crit Care Med 2011; 39 (3) 554-559
55 Fisher B, Thomas D, Peterson B. Hypertonic saline lowers raised intracranial pressure in children after head trauma. J Neurosurg Anesthesiol 1992; 4 (1) 4-10
56 Simma B, Burger R, Falk M, Sacher P, Fanconi S. A prospective, randomized, and controlled study of fluid management in children with severe head injury: lactated Ringer's solution versus hypertonic saline. Crit Care Med 1998; 26 (7) 1265-1270
57 Clifton GL, Miller ER, Choi SC , et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med 2001; 344 (8) 556-563
58 Hutchison JS, Ward RE, Lacroix J , et al; Hypothermia Pediatric Head Injury Trial Investigators and the Canadian Critical Care Trials Group. Hypothermia therapy after traumatic brain injury in children. N Engl J Med 2008; 358 (23) 2447-2456
59 Adelson PD, Ragheb J, Kanev P , et al. Phase II clinical trial of moderate hypothermia after severe traumatic brain injury in children. Neurosurgery 2005; 56 (4) 740-754 , discussion 740–754
60 Jones PA, Andrews PJ, Midgley S , et al. Measuring the burden of secondary insults in head-injured patients during intensive care. J Neurosurg Anesthesiol 1994; 6 (1) 4-14
61 Liesemer K, Bratton SL, Zebrack CM, Brockmeyer D, Statler KD. Early post-traumatic seizures in moderate to severe pediatric traumatic brain injury: rates, risk factors, and clinical features. J Neurotrauma 2011; 28 (5) 755-762
62 Chang BS, Lowenstein DH ; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: antiepileptic drug prophylaxis in severe traumatic brain injury: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2003; 60 (1) 10-16
63 Lewis RJ, Yee L, Inkelis SH, Gilmore D. Clinical predictors of post-traumatic seizures in children with head trauma. Ann Emerg Med 1993; 22 (7) 1114-1118
64 Fanconi S, Klöti J, Meuli M, Zaugg H, Zachmann M. Dexamethasone therapy and endogenous cortisol production in severe pediatric head injury. Intensive Care Med 1988; 14 (2) 163-166
65 Klöti J, Fanconi S, Zachmann M, Zaugg H. Dexamethasone therapy and cortisol excretion in severe pediatric head injury. Childs Nerv Syst 1987; 3 (2) 103-105
66 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. VI. Indications for intracranial pressure monitoring. J Neurotrauma 2007; 24 (Suppl. 01) S37-S44 Erratum in: J Neurotrauma 2008;25(3):276–8
67 Maas AI, Dearden M, Teasdale GM , et al; European Brain Injury Consortium. EBIC-guidelines for management of severe head injury in adults. Acta Neurochir (Wien) 1997; 139 (4) 286-294
68 Chesnut RM, Temkin N, Carney N , et al; Global Neurotrauma Research Group. A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 2012; 367 (26) 2471-2481
69 Tilford JM, Aitken ME, Anand KJ , et al. Hospitalizations for critically ill children with traumatic brain injuries: a longitudinal analysis. Crit Care Med 2005; 33 (9) 2074-2081
70 Güresir E, Schuss P, Seifert V, Vatter H. Decompressive craniectomy in children: single-center series and systematic review. Neurosurgery 2012; 70 (4) 881-888 , discussion 888–889
71 Oluigbo CO, Wilkinson CC, Stence NV, Fenton LZ, McNatt SA, Handler MH. Comparison of outcomes following decompressive craniectomy in children with accidental and nonaccidental blunt cranial trauma. J Neurosurg Pediatr 2012; 9 (2) 125-132
72 Pérez Suárez E, Serrano González A, Pérez Díaz C, García Salido A, Martínez de Azagra Garde A, Casado Flores J. Decompressive craniectomy in 14 children with severe head injury: clinical results with long-term follow-up and review of the literature. J Trauma 2011; 71 (1) 133-140
73 Hsiang JK, Chesnut RM, Crisp CB, Klauber MR, Blunt BA, Marshall LF. Early, routine paralysis for intracranial pressure control in severe head injury: is it necessary?. Crit Care Med 1994; 22 (9) 1471-1476
74 Skippen P, Seear M, Poskitt K , et al. Effect of hyperventilation on regional cerebral blood flow in head-injured children. Crit Care Med 1997; 25 (8) 1402-1409
75 Stringer WA, Hasso AN, Thompson JR, Hinshaw DB, Jordan KG. Hyperventilation-induced cerebral ischemia in patients with acute brain lesions: demonstration by xenon-enhanced CT. AJNR Am J Neuroradiol 1993; 14 (2) 475-484