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("Child" OR "Pediatric") AND "Head Trauma"

David Leo Jolley, Bryan Upham, Lynne Fullerton, Robert D Annett
OBJECTIVE: The objective of this study was to evaluate the effect of the Pediatric Emergency Care Applied Research Network (PECARN) blunt head trauma guidelines and implementation of urgent neurology follow-up (UNF) appointments on an observed decline in head computed tomography (CT) use for pediatric emergency department (PED) patients presenting with headache, seizure, and trauma. METHODS: Patients ages 0 to 18 years presenting to and discharged from an urban tertiary care PED with chief complaint of trauma, headache, and seizure between 2007 and 2013 were retrospectively included...
February 8, 2019: Pediatric Emergency Care
Brittany M Stopa, Stefano Amoroso, Luca Ronfani, Elena Neri, Egidio Barbi, Lois K Lee
BACKGROUND: Pediatric head trauma management varies between emergency departments globally. Here we aim to compare the pediatric minor head trauma management between a US and Italian hospital. METHODS: We conducted a retrospective chart review of children 0-18 years old presenting after minor head trauma (Glasgow Coma Scale 14-15) from two emergency departments, in Boston, Massachusetts, United States and Trieste, Italy, between January and December 2013. Frequencies of demographic, clinical, and management characteristic were calculated...
February 11, 2019: Italian Journal of Pediatrics
Mohammed Alshareef, Gibson Klapthor, Ahmed Alshareef, Zayed Almadidy, Zachary Wright, Libby Infinger, Ramin Eskandari
Cranial fasciitis is a rare benign mass that typically presents in pediatric patients from 3 weeks to 6 years of age. It is classified as a subset of nodular fasciitis that was first described in the literature in 1980. We describe the case of a 13-month-old female with a history of accidental head trauma 7 months prior to presentation and the case of a 5-month-old female with an expansile skull lesion. A systematic review of the literature on cranial fasciitis is also reported including a total of 57 published articles with 80 unique cases...
February 8, 2019: World Neurosurgery
Erik B Smith, Jennifer K Lee, Monica S Vavilala, Sarah A Lee
Pediatric traumatic brain injury (TBI) uniquely affects the pediatric population. Abusive head trauma (AHT) is a subset of severe pediatric TBI usually affecting children in the first year of life. AHT is a form of nonaccidental trauma. Sports-related TBI resulting in concussion is a milder form of TBI affecting older children. Current recommended perioperative management of AHT and sports concussions relies on general pediatric TBI guidelines. Research into more specific pediatric TBI screening and management goals is ongoing...
March 2019: Anesthesiology Clinics
Hakan Yilmaz, Ozlem Yilmaz
AIM: We investigated the pediatric patients who presented with isolated head trauma to the emergency service and where abnormal findings were detected on brain computed tomography to evaluate the follow-up scan rate and whether the follow-up scans affect the treatment protocol. MATERIAL AND METHODS: Pediatric patients who presented to the emergency service between 2014 and 2017 with isolated head trauma and were later found to have abnormal findings on CT were evaluated...
January 21, 2019: World Neurosurgery
Kavya Kommaraju, Jeffrey H Haynes, Ann M Ritter
BACKGROUND: The purpose of this study was to determine if a pediatric neurosurgical consultation for isolated linear skull fractures (ILSF) in pediatric patients with Glasgow Coma Scale (GCS) scores of ≥14 changed their management. METHODS: A 10-year retrospective chart review at a Level 1 Pediatric Trauma Center was performed. Exclusion criteria were age > 18 years, open, depressed, or skull base fractures, pneumocephalus, poly-trauma, any hemorrhage (intraparenchymal, epidural, subdural, subarachnoid), cervical spine fractures, penetrating head trauma, and initial GCS scores ≤13...
January 23, 2019: Pediatric Neurosurgery
Daniel J Corwin, Dennis R Durbin, Katie L Hayes, Mark R Zonfrillo
OBJECTIVE: The aims of this study were to evaluate trends over time in computed tomography (CT) scan utilization after implementation of a clinical pathway in a tertiary care children's hospital emergency department (ED), to determine how ED throughput differs by CT utilization, and to determine provider reasoning for obtaining head CT in low-risk patients. METHODS: This was a retrospective cohort study of patients 21 years or younger discharged from our ED with head trauma (Glasgow Coma Scale score ≥13 and a head trauma International Classification of Diseases code) over a 5-year period, starting 1 year after pathway implementation (January 2012 to December 2016)...
January 21, 2019: Pediatric Emergency Care
Emily A Eismann, Eve S Pearl, Jack Theuerling, Alonzo T Folger, John S Hutton, Kathi Makoroff
BACKGROUND: Abusive head trauma (AHT) is a preventable form of child abuse. OBJECTIVE: This project used a mixed method design to assess the feasibility of the Calm Baby Gently educational baby book intervention for promoting safe practices related to infant crying in an effort to prevent AHT. PARTICIPANTS AND SETTING: Three pediatric practices participated between June 2016 and January 2018, including 1045 caregivers who attended their infant's 2-month well-child visit...
January 15, 2019: Child Abuse & Neglect
Burak Eren, Abdurrahim Tas, Feyza Karagoz Guzey, Ilker Gulec, Azmi Tufan, Murat Karacan
AIM: The purpose of this study is to identify, report, and raise awareness of the risk factors for television (TV) tip-over. MATERIAL AND METHODS: In total, 86 children who were brought to the emergency service and hospitalized in the neurosurgery clinic between August 2011 and August 2016 because of TV tip-over-related head trauma were included in the study. RESULTS: Of these 86 patients, 47 boys and 39 girls. The mean age was 38.8 ± 19...
June 11, 2018: Turkish Neurosurgery
En-Pei Lee, Jainn-Jim Lin, Shao-Hsuan Hsia, Oi-Wa Chan, Han-Ping Wu
BACKGROUND: Pneumatosis intestinalis and portomesenteric venous gas are usually caused by necrotizing enterocolitis; however they can occur secondary to abusive abdominal trauma with bone fractures and bruising. It is difficult to recognize initially if there is no bruising on the skin or bone fractures. CASE PRESENTATION: We report a 1-year-old child with no obvious history of trauma who presented with conscious disturbance. Abdominal computed tomography showed acute ischemic bowel complicated with pneumatosis intestinalis and portomesenteric venous gas...
January 15, 2019: BMC Pediatrics
Erik P Hess, James L Homme, Anupam B Kharbanda, Leah Tzimenatos, Jeffrey P Louie, Daniel M Cohen, Lise E Nigrovic, Jessica J Westphal, Nilay D Shah, Jonathan Inselman, Michael J Ferrara, Jeph Herrin, Victor M Montori, Nathan Kuppermann
Importance: The Pediatric Emergency Care Applied Research Network prediction rules for minor head trauma identify children at very low, intermediate, and high risk of clinically important traumatic brain injuries (ciTBIs) and recommend no computed tomography (CT) for those at very low risk. However, the prediction rules provide little guidance in the choice of home observation or CT in children at intermediate risk for ciTBI. Objective: To compare a decision aid with usual care in parents of children at intermediate risk for ciTBI...
September 7, 2018: JAMA network open
Angell Shi, Abhaya Kulkarni, Kenneth W Feldman, Avery Weiss, Emily A McCourt, Susan Schloff, Michael Partington, Brian Forbes, Brooke E Geddie, Karin Bierbrauer, Paul H Phillips, David L Rogers, Waleed Abed Alnabi, Gil Binenbaum, Alex V Levin
OBJECTIVES: Increased intracranial pressure (ICP) has been suggested in legal settings as an alternative cause of retinal hemorrhages (RHs) in young children who may have sustained abusive head trauma. We assessed the prevalence and characteristics of RHs in children with increased ICP. METHODS: We conducted a prospective, multicenter study of children <4 years old with newly diagnosed increased ICP as determined by using direct measurement and/or clinical criteria...
January 10, 2019: Pediatrics
Mohammad Vafaeeshahi, Nazanin Azizishalbaf, Leila Tahernia
Cerebellar acute ischemic stroke (AIS) can be a complication of minor head trauma, vertebral artery dissection, vasospasm or systemic hypoperfusion. CT scan usually is negative few hours after acute infarction. Magnetic resonance imaging (MRI) is superior to CT scan for posterior fossa lesions and also in acute phase of cerebellar stroke especially in children. Here we report a 9 yr old girl referred to the Pediatric Emergency Room, Moosavi Hospital, Zanjan, Iran in January 2017 presenting with sudden onset of headache and recurrent vomiting, ataxia, and history of 3 consecutive days of fever and malaise...
2019: Iranian Journal of Child Neurology
Charmaine Childs, Lynne A Barker, Alex Md Gage, Mike Loosemore
Purpose: Changes to retina have been reported after a number of neurodegenerative conditions. The purpose of this study was to investigate retinal structures in Olympic boxers exposed to frequent head blows. Methods: Retinal imaging offers potential as a non-invasive biomarker of neuropathology. Macula and retinal nerve fiber layer (RNFL) thickness was measured using optical coherence tomography (OCT) in UK Olympic boxers attending two mandatory eye screening programs, 18 months apart...
2018: Eye and Brain
Dustin W Ballard, Nathan Kuppermann, David R Vinson, Eric Tham, Jeff M Hoffman, Marguerite Swietlik, Sara J Deakyne Davies, Evaline A Alessandrini, Leah Tzimenatos, Lalit Bajaj, Dustin G Mark, Steve R Offerman, Uli K Chettipally, Marilyn D Paterno, Molly H Schaeffer, Rachel Richards, T Charles Casper, Howard S Goldberg, Robert W Grundmeier, Peter S Dayan
STUDY OBJECTIVE: To determine the effect of providing risk estimates of clinically important traumatic brain injuries and management recommendations on emergency department (ED) outcomes for children with isolated intermediate Pediatric Emergency Care Applied Research Network clinically important traumatic brain injury risk factors. METHODS: This was a secondary analysis of a nonrandomized clinical trial with concurrent controls, conducted at 5 pediatric and 8 general EDs between November 2011 and June 2014, enrolling patients younger than 18 years who had minor blunt head trauma...
December 22, 2018: Annals of Emergency Medicine
Sarah J Kizilbash, Michelle N Rheault, Qi Wang, David M Vock, Srinath Chinnakotla, Tim Pruett, Blanche M Chavers
Increased risk donors (IRDs) may inadvertently transmit blood-borne viruses to organ recipients through transplant. Rates of IRD kidney transplants in children and the associated outcomes are unknown. We used the Scientific Registry of Transplant Recipients to identify pediatric deceased donor kidney transplants that were performed in the United States between January 1, 2005 and December 31, 2015. We used the Cox regression analysis to compare patient and graft survival between IRD and non-IRD recipients, and a sequential Cox approach to evaluate survival benefit after IRD transplants compared with remaining on the waitlist and never accepting an IRD kidney...
December 23, 2018: American Journal of Transplantation
Kent P Hymel, Ming Wang, Vernon M Chinchilli, Wouter A Karst, Douglas F Willson, Mark S Dias, Bruce E Herman, Christopher L Carroll, Suzanne B Haney, Reena Isaac
BACKGROUND: Evidence-based, patient-specific estimates of abusive head trauma probability can inform physicians' decisions to evaluate, confirm, exclude, and/or report suspected child abuse. OBJECTIVE: To derive a clinical prediction rule for pediatric abusive head trauma that incorporates the (positive or negative) predictive contributions of patients' completed skeletal surveys and retinal exams. PARTICIPANTS AND SETTING: 500 acutely head-injured children under three years of age hospitalized for intensive care at one of 18 sites between 2010 and 2013...
December 11, 2018: Child Abuse & Neglect
Arturo Loredo-Abdalá, Abigail Casas-Muñoz, Gabriel Alejandro González-Garay, Raquel Ortiz-Hernández, Jessica María González-Corona, Leslie Viridiana Ramírez-Angoa
Introduction: Abusive head trauma (AHT) is an extreme form of physical abuse that is produced by abruptly shaking an infant or toddler. Objective: To describe the direct economic cost of care during hospitalization of 14 children with confirmed diagnosis of AHT in a pediatric hospital. Method: Analysis of the cost of disease in patients with AHT attended to between 2001 and 2010. Partial direct economic cost of medical care (days of hospital stay, laboratory tests and imaging studies, surgical procedures and subspecialist consultations) was calculated adjusting for inflation, with year 2001 taken as base year...
2018: Gaceta Médica de México
Guyon J Hill, Michael D April, Joseph K Maddry, Steven G Schauer
BACKGROUND: Head injuries frequently occur in combat. Tactical Combat Casualty Care (TCCC) guidelines recommend pre-hospital use of ketamine for analgesia. Yet the use of this medication in patients with head injuries remains controversial, particularly among pediatric patients. We compare survival to hospital discharge rates among pediatric head injury subjects who received prehospital ketamine versus those who did not. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric (<18 years of age) subjects from January 2007 to January 2016...
October 22, 2018: American Journal of Emergency Medicine
D Wittschieber, B Karger, H Pfeiffer, M L Hahnemann
Life-threatening physical abuse of infants and toddlers is frequently correlated with head injuries. A common variant of the abusive head trauma is the shaken baby syndrome. The present review article sheds light on subdural collections in children with abusive head trauma and aims at providing a recent knowledge base for various medical disciplines involved in diagnostic procedures and legal proceedings. To this end, the different subdural collection entities are presented and illustrated. The pathophysiologic background is explained...
December 6, 2018: AJNR. American Journal of Neuroradiology
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