Pediatric Head Trauma

Excerpt

Traumatic brain injury (TBI) is a significant contributor to mortality and disability among children aged 1 to 18. The condition is a disruption in the brain's normal function caused by a mechanical impact on the head. TBI is typically classified as mild, moderate, or severe based on the Glasgow Coma Scale (GCS) and can have fatal consequences. Patients with a GCS score of 14 to 15 are categorized as having mild TBI, whereas those with a GCS score of 9 to 13 are classified as having moderate TBI. Patients with a GCS score of 3 to 8 are considered to have severe TBI. Children with severe TBI are at high risk of mortality and neurological morbidity.

TBI can be conceptualized as a primary injury occurring at the moment of impact, followed by secondary damage resulting from various factors such as intracranial hematomas, ischemia, edema, vasospasm, and hypoxemia. Annually, pediatric TBI leads to more than 500,000 visits to emergency departments and approximately 60,000 hospitalizations in the United States. Males across all pediatric age groups are more prone to TBI compared to females. Implementing primary prevention strategies, avoiding secondary neurological injury, establishing organized trauma systems, and promptly diagnosing and treating elevated intracranial pressure (ICP) can mitigate the adverse effects of severe TBI. Consequently, these measures lead to decreased morbidity and mortality among children.