Pediatric head injury: what is unique and different

Abstract

Pediatric head injury has unique issues that make patient management and outcome different from that of adult head injury. The differences may be classified in various categories. The mechanism of injury may be that of accidental or non-accidental trauma, and in the latter, repeated secondary insults will affect patient management and outcome. Age related aspects will determine a greater or lesser degree of craniocervical junction injuries (disproportionate cranial size to trunk in infancy and early childhood). Other factors are potential underlying congenital anomalies, physiological factors (cerebrovascular reactivity and blood flow), differing support systems needed from that of adults for neuro imaging and specialized medical, nursing and allied health care support. Pediatric rehabilitation and educational needs and goals are different to that of adult head injury. Neurological recovery in non-accidental trauma is uniformly poor, when compared to accidental trauma. Pediatric head injury has unique requirements in early field management, hospital management, rehabilitation and educational needs, as well as community re-entry programmes.