scholarly journals Traumatic Brain Injury in Children

2021 ◽  
Author(s):  
Dyah Kanya Wati
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Behavioral Problems ◽  
The United States ◽  
Normal Brain ◽  
Injury Rates ◽  
Small Loss ◽  
Normal Brain Function ◽  
Pediatric Tbi ◽  
Incident Rates

Traumatic brain injury (TBI) in children occurs as a result of a sudden bump, roll, or jerk to the head or a penetrating injury to the head that interferes the normal brain function. Traumatic brain injury (TBI) is the leading cause of death and disability in children. More than half a million children present annually to the emergency department for TBI-related visits, and resulting in the death of >7,000 children annually in the United States, with highest incident rates seen in children aged 0–4 years and adolescents aged 15 to 19 years. In Indonesia, from Riskesdas data in 2013 shows the incidence of head trauma in children is about 0.5% of the population from other injury rates. Pediatric TBI is associated with an array of negative outcomes, including impaired cognitive and academic abilities, social impairments, and behavioral problems. The scalp is highly vascularized and a potential cause of lethal blood loss. Even a small loss of blood volume can lead to hemorrhagic shock in a newborn, infant, and toddler, which may occur without apparent external bleeding.

scholarly journals Pediatric Traumatic Brain Injury in the United States: Rural-Urban Disparities and Considerations

2020 ◽  
Vol 10 (3) ◽  
pp. 135 ◽  
Author(s):  
John K. Yue ◽  
Pavan S. Upadhyayula ◽  
Lauro N. Avalos ◽  
Tene A. Cage
Keyword(s):  
Mental Health ◽  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Healthcare Costs ◽  
Motor Vehicle ◽  
The United States ◽  
Pubmed Database ◽  
Pediatric Tbi

Introduction: Traumatic brain injury (TBI) remains a primary cause of pediatric morbidity. The improved characterization of healthcare disparities for pediatric TBI in United States (U.S.) rural communities is needed to advance care. Methods: The PubMed database was queried using keywords ((“brain/head trauma” OR “brain/head injury”) AND “rural/underserved” AND “pediatric/child”). All qualifying articles focusing on rural pediatric TBI, including the subtopics epidemiology (N = 3), intervention/healthcare cost (N = 6), and prevention (N = 1), were reviewed. Results: Rural pediatric TBIs were more likely to have increased trauma and head injury severity, with higher-velocity mechanisms (e.g., motor vehicle collisions). Rural patients were at risk of delays in care due to protracted transport times, inclement weather, and mis-triage to non-trauma centers. They were also more likely than urban patients to be unnecessarily transferred to another hospital, incurring greater costs. In general, rural centers had decreased access to mental health and/or specialist care, while the average healthcare costs were greater. Prevention efforts, such as mandating bicycle helmet use through education by the police department, showed improved compliance in children aged 5–12 years. Conclusions: U.S. rural pediatric patients are at higher risk of dangerous injury mechanisms, trauma severity, and TBI severity compared to urban. The barriers to care include protracted transport times, transfer to less-resourced centers, increased healthcare costs, missing data, and decreased access to mental health and/or specialty care during hospitalization and follow-up. Preventative efforts can be successful and will require an improved multidisciplinary awareness and education.

scholarly journals Pathophysiology of Pediatric Traumatic Brain Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Rebecka O. Serpa ◽  
Lindsay Ferguson ◽  
Cooper Larson ◽  
Julie Bailard ◽  
Samantha Cooke ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pediatric Population ◽  
Age Groups ◽  
Bimodal Distribution ◽  
The United States ◽  
Research Progress ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Pediatric Tbi

The national incidence of traumatic brain injury (TBI) exceeds that of any other disease in the pediatric population. In the United States the Centers for Disease Control and Prevention (CDC) reports 697,347 annual TBIs in children ages 0–19 that result in emergency room visits, hospitalization or deaths. There is a bimodal distribution within the pediatric TBI population, with peaks in both toddlers and adolescents. Preclinical TBI research provides evidence for age differences in acute pathophysiology that likely contribute to long-term outcome differences between age groups. This review will examine the timecourse of acute pathophysiological processes during cerebral maturation, including calcium accumulation, glucose metabolism and cerebral blood flow. Consequences of pediatric TBI are complicated by the ongoing maturational changes allowing for substantial plasticity and windows of vulnerabilities. This review will also examine the timecourse of later outcomes after mild, repeat mild and more severe TBI to establish developmental windows of susceptibility and altered maturational trajectories. Research progress for pediatric TBI is critically important to reveal age-associated mechanisms and to determine knowledge gaps for future studies.

scholarly journals Role of Exosomes in Brain Diseases

2021 ◽  
Vol 15 ◽  
Author(s):  
Nan Zhang ◽  
Fengling He ◽  
Ting Li ◽  
Jinzhi Chen ◽  
Liping Jiang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Function ◽  
Host Cells ◽  
Brain Diseases ◽  
Normal Brain ◽  
Normal Brain Function ◽  
Target Molecules ◽  
Non Coding Rnas

Exosomes are a subset of extracellular vesicles that act as messengers to facilitate communication between cells. Non-coding RNAs, proteins, lipids, and microRNAs are delivered by the exosomes to target molecules (such as proteins, mRNAs, or DNA) of host cells, thereby playing a key role in the maintenance of normal brain function. However, exosomes are also involved in the occurrence, prognosis, and clinical treatment of brain diseases, such as Alzheimer's disease, Parkinson's disease, stroke, and traumatic brain injury. In this review, we have summarized novel findings that elucidate the role of exosomes in the occurrence, prognosis, and treatment of brain diseases.

scholarly journals Clinical trials for pediatric traumatic brain injury: definition of insanity?

2019 ◽  
Vol 23 (6) ◽  
pp. 661-669 ◽  
Author(s):  
Brian Appavu ◽  
Stephen T. Foldes ◽  
P. David Adelson
Keyword(s):  
Traumatic Brain Injury ◽  
Clinical Trials ◽  
Brain Injury ◽  
The United States ◽  
Pediatric Traumatic Brain Injury ◽  
Definition Of ◽  
High Level ◽  
Pediatric Tbi ◽  
Current Guidelines ◽  
Injury Definition

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children both in the United States and throughout the world. Despite valiant efforts and multiple clinical trials completed over the last few decades, there are no high-level recommendations for pediatric TBI available in current guidelines. In this review, the authors explore key findings from the major pediatric clinical trials in children with TBI that have shaped present-day recommendations and the insights gained from them. The authors also offer a perspective on potential efforts to improve the efficacy of future clinical trials in children following TBI.

scholarly journals Pediatric Sleep Difficulties after Moderate–Severe Traumatic Brain Injury

2013 ◽  
Vol 19 (7) ◽  
pp. 829-834 ◽  
Author(s):  
Ruth E. Sumpter ◽  
Liam Dorris ◽  
Thomas Kelly ◽  
Thomas M. McMillan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Behavioral Problems ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Self Report ◽  
Sleep Habits ◽  
Severe Tbi ◽  
Pediatric Tbi ◽  
Sleep Difficulties

AbstractThe objective of this study is to systematically investigate sleep following moderate–severe pediatric traumatic brain injury (TBI). School-aged children with moderate–severe TBI identified via hospital records were invited to participate, along with a school-age sibling. Subjective reports and objective actigraphy correlates of sleep were recorded: Children's Sleep Habits Questionnaire (CSHQ), Sleep Self-Report questionnaire (SSR), and 5-night actigraphy. TBI participants (n= 15) and their siblings (n= 15) participated. Significantly more sleep problems were parent-reported (CSHQ:p= 0.003;d= 1.57), self-reported (SSR:p= 0.003;d= 1.40), and actigraph-recorded in the TBI group (sleep efficiency:p= 0.003;d= 1.23; sleep latency:p= 0.018;d= 0.94). There was no evidence of circadian rhythm disorders, and daytime napping was not prevalent. Moderate–severe pediatric TBI was associated with sleep inefficiency in the form of sleep onset and maintenance problems. This preliminary study indicates that clinicians should be aware of sleep difficulties following pediatric TBI, and their potential associations with cognitive and behavioral problems in a group already at educational and psychosocial risk. (JINS, 2013,19, 1–6)

Fifteen-minute consultation: Severe traumatic brain injury in paediatrics

2020 ◽  
pp. edpract-2019-318246
Author(s):  
Seana Molloy ◽  
Gemma Batchelor ◽  
Peter Mallett ◽  
Andrew Thompson ◽  
Thomas Bourke ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Function ◽  
Penetrating Trauma ◽  
Normal Brain ◽  
Stages Of Development ◽  
Normal Brain Function ◽  
Severe Tbi ◽  
Over Time

Paediatric traumatic brain injury (TBI) is a non-degenerative, acquired brain insult. Following a blow or penetrating trauma to the head, normal brain function is disrupted. If it occurs during the early stages of development, deficits may not immediately become apparent but unfold and evolve over time. We address the difficulties that arise when treating a child with severe TBI.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

One-year costs of intensive care in pediatric patients with traumatic brain injury

2021 ◽  
Vol 27 (1) ◽  
pp. 79-86
Author(s):  
Era D. Mikkonen ◽  
Markus B. Skrifvars ◽  
Matti Reinikainen ◽  
Stepani Bendel ◽  
Ruut Laitio ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Social Security ◽  
Functional Outcome ◽  
Injury Severity ◽  
Pediatric Population ◽  
Favorable Outcome ◽  
Index Hospitalization ◽  
Pediatric Tbi

OBJECTIVETraumatic brain injury (TBI) is a major cause of death and disability in the pediatric population. The authors assessed 1-year costs of intensive care in pediatric TBI patients.METHODSIn this retrospective multicenter cohort study of four academic ICUs in Finland, the authors used the Finnish Intensive Care Consortium database to identify children aged 0–17 years treated for TBI in ICUs between 2003 and 2013. The authors reviewed all patient health records and head CT scans for admission, treatment, and follow-up data. Patient outcomes included functional outcome (favorable outcome defined as a Glasgow Outcome Scale score of 4–5) and death within 6 months. Costs included those for the index hospitalization, rehabilitation, and social security up to 1 year after injury. To assess costs, the authors calculated the effective cost per favorable outcome (ECPFO).RESULTSIn total, 293 patients were included, of whom 61% had moderate to severe TBI (Glasgow Coma Scale [GCS] score 3–12) and 40% were ≥ 13 years of age. Of all patients, 82% had a favorable outcome and 9% died within 6 months of injury. The mean cost per patient was €48,719 ($54,557) (95% CI €41,326–€56,112). The index hospitalization accounted for 66%, rehabilitation costs for 27%, and social security costs for 7% of total healthcare costs. The ECPFO was €59,727 ($66,884) (95% CI €52,335–€67,120). A higher ECPFO was observed among patients with clinical and treatment-related variables indicative of parenchymal swelling and high intracranial pressure. Lower ECPFO was observed among patients with higher admission GCS scores and those who had epidural hematomas.CONCLUSIONSGreater injury severity increases ECPFO and is associated with higher postdischarge costs in pediatric TBI patients. In this pediatric cohort, over two-thirds of all resources were spent on patients with favorable functional outcome, indicating appropriate resource allocation.

Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases

2020 ◽  
pp. 1-10
Author(s):  
Brittany M. Stopa ◽  
Maya Harary ◽  
Ray Jhun ◽  
Arun Job ◽  
Saef Izzy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Data Bank ◽  
The United States ◽  
National Sample ◽  
Population Based ◽  
Weighted Estimates ◽  
True Incidence ◽  
Ed Visits

OBJECTIVETraumatic brain injury (TBI) is a leading cause of morbidity and mortality in the US, but the true incidence of TBI is unknown.METHODSThe National Trauma Data Bank National Sample Program (NTDB NSP) was queried for 2007 and 2013, and population-based weighted estimates of TBI-related emergency department (ED) visits, hospitalizations, and deaths were calculated. These data were compared to the 2017 Centers for Disease Control and Prevention (CDC) report on TBI, which used the Healthcare Cost and Utilization Project’s National (“Nationwide” before 2012) Inpatient Sample and National Emergency Department Sample.RESULTSIn the NTDB NSP the incidence of TBI-related ED visits was 59/100,000 in 2007 and 62/100,000 in 2013. However, in the CDC report there were 534/100,000 in 2007 and 787/100,000 in 2013. The CDC estimate for ED visits was 805% higher in 2007 and 1169% higher in 2013. In the NTDB NSP, the incidence of TBI-related deaths was 5/100,000 in 2007 and 4/100,000 in 2013. In the CDC report, the incidence was 18/100,000 in both years. The CDC estimate for deaths was 260% higher in 2007 and 325% higher in 2013.CONCLUSIONSThe databases disagreed widely in their weighted estimates of TBI incidence: CDC estimates were consistently higher than NTDB NSP estimates, by an average of 448%. Although such a discrepancy may be intuitive, this is the first study to quantify the magnitude of disagreement between these databases. Given that research, funding, and policy decisions are made based on these estimates, there is a need for a more accurate estimate of the true national incidence of TBI.

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