Pediatric emergency medicine trisk 909
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CHAPTER 113 ■ NEUROTRAUMA
JULIE McMANEMY, ANDREW JEA, KATRINA DUCIS
GOALS OF EMERGENCY THERAPY
Head injury is a common presentation in the pediatric emergency
department (ED). The challenge is to distinguish minor head trauma from
clinically important traumatic brain injury (ciTBI). Identifying which
children necessitate radiographic imaging and immediate recognition of
ciTBI should be the goal of the evaluation. Management of the head injured
child should focus on stabilization, recognition of clinical deterioration, and
early consultation of a neurosurgeon to decrease morbidity and mortality.
KEY POINTS
Headache is a common presenting symptom.
Most head injuries are minor and do not necessitate clinical
interventions.
Infants with intracranial injuries may appear to be asymptomatic
due to limitations in their neurologic examination.
The most common cause of mortality from child abuse is head
trauma.
Cervical spine injury in children is rare, but occurs with traumatic
brain injury (TBI) in 20% of patients.
RELATED CHAPTERS
Signs and Symptoms
Injury: Head: Chapter 41
Pain: Headache: Chapter 59
Vomiting: Chapter 81
Medical, Surgical, and Trauma Emergencies
A General Approach to the Ill or Injured Child: Chapter 7
Neurosurgical Emergencies: Chapter 122
Child Abuse/Assault: Chapter 87
The Children’s Hospital of Philadelphia Clinical Pathways
ED Pathway for Evaluation/Treatment of Children With Sexual
Abuse Concerns
URL: />Authors: J. Lavelle, MD; J. Molnar, MSN, PNP-BC; C. Christian,
MD; S. Frioux, MD; P. Scribano, DO
Posted: May 2018, last revised October 2018
ED Pathway for Evaluation and Treatment of Acute Head
Trauma
URL: />Authors: M. Zonfrillo, MD; F. Nadel, MD; D. Corwin, MD; M.
Mittal, MD; C. Jacobstein, MD; J. Lavelle, MD; P. Scribano, DO
Posted: December 2010, last revised July 2019
NEUROTRAUMA
Blunt Head Injury
CLINICAL PEARLS AND PITFALLS
