J Korean Neurosurg Soc.  2022 May;65(3):354-360. 10.3340/jkns.2021.0308.

Pediatric Severe Traumatic Brain Injury : Updated Management

• Ha EJ

• KMID: 2529579
• DOI: http://doi.org/10.3340/jkns.2021.0308

Abstract

Traumatic brain injury (TBI) is the leading cause of death and disability in children. Survivors of severe TBI are more susceptible to functional deficits, resulting in disability, poor quality of life, cognitive decline, and mental health problems. Despite this, little is known about the pathophysiology of TBI in children and how to manage it most effectively. Internationally, efforts are being made to expand knowledge of pathophysiology and develop practical clinical treatment recommendations to improve outcomes. Here we discuss recently updated evidence and management of severe pediatric TBI.

Keyword

Traumatic brain injury; Pediatrics; Critical care; Intracranial pressure; Practice guideline

Figure

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  Fig. 1. The evidence- and consensus-based algorithm of the management for the severe TBI in pediatric patients. The algorithm includes several components, such as baseline care (black), an ICP pathway (yellow), a herniation pathway (green), a CPP pathway (orange), and a PbrO2 pathway (purple). Solid lines identify the ICP and CPP pathways, reflecting their primary role. If baseline care is insufficient to control ICP, first-tier interventions progressing down the ICP pathway. The blue box indicates the need for second-tier therapy. TBI : traumatic brain injury, GCS : Glasgow coma scale, CT : computed tomography, ICP : intracranial pressure, PbrO2 : brain tissue partial pressure of oxygen, CPP : cerebral perfusion pressure

Reference

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