title: Pathophysiology and Management of Moderate and Severe Traumatic Brain Injury in Children.
abstract: Traumatic brain injury remains a leading cause of morbidity and mortality in children. Key pathophysiologic processes of traumatic brain injury are initiated by mechanical forces at the time of trauma, followed by complex excitotoxic cascades associated with compromised cerebral autoregulation and progressive edema. Acute care focuses on avoiding secondary insults, including hypoxia, hypotension, and hyperthermia. Children with moderate or severe traumatic brain injury often require intensive monitoring and treatment of multiple parameters, including intracranial pressure, blood pressure, metabolism, and seizures, to minimize secondary brain injury. Child neurologists can play an important role in acute and long-term care. Acutely, as members of a multidisciplinary team in the intensive care unit, child neurologists monitor for early signs of neurological change, guide neuroprotective therapies, and transition patients to long-term recovery. In the longer term, neurologists are uniquely positioned to treat complications of moderate and severe traumatic brain injury, including epilepsy and cognitive and behavioral issues.
authors.affiliation: Department of Neurology, Division of Pediatric and Developmental Neurology, and Department of Pediatrics, Division of Critical Care Medicine, Washington University School of Medicine, St. Louis, MO, USA guilliamsk@neuro.wustl.edu.
authors.forename: Kristin
authors.initials: K
authors.lastname: Guilliams
authors.affiliation: Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA Department of Pediatrics, Divisions of Neurology and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Wainwright
mesh_terms: D001930:Brain Injuries / Q000503:physiopathology* / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D010372:Pediatrics
keywords: closed head injury; intracranial pressure; pediatric brain trauma; pediatric neurocritical care