Severe Traumatic Brain Injuries in Children

Severe traumatic brain injury in the pediatric age group is a serious public health problem. Societal goals must prioritize safety in automobiles, bicycles, and sports to prevent primary (physical) injuries. Parents and health care workers must be aware of strategies to prevent and detect nonaccidental injuries to infants and toddlers. There are unacceptably high mortality and morbidity rates, robbing decades of functional years from its victims, at a very high personal and financial cost. With appropriate and effective emergency management and expeditious referral to a trauma center with neurosurgical expertise in the pediatric population, the management of these children and eventual outcome can be optimized. Meticulous and conscientious attention to basic systemic care is the foundation of excellent brain trauma management and may help to reduce the impact of secondary injury. Although there is a lack of prospective, randomized, clinical trials in the management of traumatic brain injury in the pediatric population, expert consensus recommendations based on vast empirical experience, some clinical trials, and adult guidelines have been published.