Management of Head Injury in Children

Abstract

Head injury is a global health problem. Especially with children, head injuries are among the three most common causes of neurodisability and death. Most common mechanisms for head injury in children are fall and being struck by an object. An unique aspect about traumatic brain injury (TBI) with children is the inclusion of child abuse related injuries. Clinically, the severity of the disease can be determined by assessing the level of consciousness throughout  Glasgow Coma Scale (GCS). Classification of  the injuries severity has a major impact on further treatment. Radiological imaging of the choice is the computer tomography (CT) scan. Conservative treatment including oxygenation and maintaining intracranial pressure are mandatory to prevent secondary brain injury. Brain monitoring, especially tracking of intracranial cerebral pressure, has a major impact on severe head injury management. Blood biomarkers are used occasional to detect disease progression in subacute phase.  Surgical intervention does not improve outcome necessarily.

^[1] Maas A.I.R, Menon D.K, Adelson P.D, et al., Traumatic brain injury: integrated approaches to improve prevention clinical care and research. Lancet Neurol 2017; 1474-4422.

^[2] Maas A.I.R, et al., Traumatic brain injury: integrated approaches to improve prevention clinical care and research.