Pediatric minor closed head injury

Mary L. Thiessen, Dale P Woolridge

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Many studies have found conflicting evidence over the use of clinical indicators to predict ICI in pediatric MHI. Although altered mental status, LOC, and abnormal neurologic examination findings have all been found to be more prevalent among head-injured children, studies have observed inconsistent results over their specificity and predictive value. Children older than 2 years have been evaluated, managed, and studied differently than those younger than 2 years. Evidence strongly supports a lower threshold for performing a CT scan in younger children because they have a higher risk of significant brain injury after blunt head trauma. Many authors state that children with MHI who have normal CT scan results and normal mental status and neurologic examination findings may be discharged from the ED with a reliable caregiver and detailed head injury instructions. Further research involving multicenter trials with prospective enrollment will help to validate the decision making and previous recommendations on neuroimaging, hospitalization, observation, and discharge. Currently, the Pediatric Emergency Care Applied Research Network is conducting a multicenter study to address these questions. This study is currently in progress and has enrolled 16,000 children, with plans to enroll over 25,000 children. One of the goals is to create a neuroimaging decision rule on children with minor to moderate head trauma. Most children with MHI make a full recovery; however, a subset of children with preinjury morbidity may develop neuropsychologic sequelae. The management of sports-related head injuries demands identifying potential neurosurgical emergencies and preventing catastrophic outcomes related to acute brain swelling and repetitive concussions.

Original languageEnglish (US)
Pages (from-to)1-26
Number of pages26
JournalPediatric Clinics of North America
Volume53
Issue number1
DOIs
StatePublished - Feb 2006

Fingerprint

Closed Head Injuries
Craniocerebral Trauma
Pediatrics
Neurologic Examination
Neurologic Manifestations
Neuroimaging
Multicenter Studies
Brain Edema
Emergency Medical Services
Research
Brain Injuries
Caregivers
Sports
Decision Making
Hospitalization
Emergencies
Head
Observation
Morbidity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Pediatric minor closed head injury. / Thiessen, Mary L.; Woolridge, Dale P.

In: Pediatric Clinics of North America, Vol. 53, No. 1, 02.2006, p. 1-26.

Research output: Contribution to journalArticle

Thiessen, Mary L. ; Woolridge, Dale P. / Pediatric minor closed head injury. In: Pediatric Clinics of North America. 2006 ; Vol. 53, No. 1. pp. 1-26.
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