Management of Head Injury: Special Considerations in Children
Pediatric traumatic brain injuries encompass a wide range of diagnoses from mild concussions to life-threatening intracranial hemorrhages requiring neurosurgical intervention. Management of these injuries requires an in-depth understanding of the neurobiology of the developing brain. Recognition of cellular and physiologic mechanisms unique to pediatric patients is a crucial part of decision making in immediate stabilization efforts. Neurocritical care management focuses not only on the initial hemodynamic resuscitation but also on the prevention of secondary injury and should be initiated as early as possible with a focus on maintaining normal oxygenation, temperature, and ventilation. Children are at risk of specific, age-dependent neurological effects, which not only will impact their short-term recovery but also can initiate a cascade of lifelong sequelae. Optimization of outcomes requires collaboration of multiple services and specialties with a goal of preserving potential functional capacity in the immature brain.
