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. This article reviews the epidemiology, mechanisms, clinical signs, and management of AHT and sports-related concussions.
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http://dx.doi.org/10.1016/j.anclin.2018.10.002 | DOI Listing |
Sci Transl Med
March 2025
Clinical Neuroscience Research Center, Department of Neurosurgery and Neurology, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Traumatic brain injury (TBI) rapidly triggers proinflammatory activation of microglia, contributing to secondary brain damage post-TBI. Although the governing role of energy metabolism in shaping the inflammatory phenotype and function of immune cells has been increasingly recognized, the specific alterations in microglial bioenergetics post-TBI remain poorly understood. Itaconate, a metabolite produced by the enzyme aconitate decarboxylase 1 [IRG1; encoded by immune responsive gene 1 ()], is a pivotal metabolic regulator in immune cells, particularly in macrophages.
View Article and Find Full Text PDFJAMA Netw Open
March 2025
Children's Intensive Care Unit, SingHealth Paediatrics Academic Clinical Programme, KK Women's and Children's Hospital, Singapore.
Importance: The use of hypertonic saline (HTS) vs mannitol in the control of elevated intracranial pressure (ICP) secondary to neurotrauma is debated.
Objective: To compare mortality and functional outcomes of treatment with 3% HTS vs 20% mannitol among children with moderate to severe traumatic brain injury (TBI) at risk of elevated ICP.
Design, Setting, And Participants: This prospective, multicenter cohort study was conducted between June 1, 2018, and December 31, 2022, at 28 participating pediatric intensive care units in the Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) in Asia, Latin America, and Europe.
J Sleep Res
March 2025
VA Portland Health Care System, Research Service, Portland, Oregon, USA.
Individuals with comorbid rapid eye movement (REM) sleep behaviour disorder (RBD) and neurotrauma (NT; defined by traumatic brain injury and post-traumatic stress disorder) have an earlier age of RBD symptom onset, increased RBD-related symptom severity and more neurological features indicative of prodromal synucleinopathy compared to RBD only. An early sign of neurodegenerative condition is autonomic dysfunction, which we sought to evaluate by examining heart rate variability during sleep. Participants with overnight polysomnography were recruited from the Veterans Affairs Portland Health Care System.
View Article and Find Full Text PDFJ Trauma Acute Care Surg
March 2025
From the Division of Acute Care Surgery, Department of Surgery (M.K., S.D., M.J.M., K.I., K.M.), Los Angeles General Medical Center, University of Southern California, Los Angeles, California; Human Health Sciences (M.K., S.F.), Kyoto University Graduate School of Medicine, Kyoto; Department of Epidemiology Infectious Disease Control and Prevention (S.F.), Hiroshima University Graduate school of Biomedical and Health Sciences, Hiroshima, Japan; SSM Cardinal Glennon Children's Hospital (S.M.), St. Louis University School of Medicine, Saint Louis, Missouri; and Data Science and AI Innovation Research Promotion Center (T.I.), Shiga University, Shiga, Japan.
Background: While severe traumatic brain injury (TBI) faces an increased risk of venous thromboembolism (VTE), pharmacological VTE prophylaxis might be significantly delayed because of concerns for TBI progression. We aimed to assess practice variations in the rate and timing of VTE prophylaxis for adolescent patients with severe TBI between different trauma center types.
Methods: This retrospective cohort study using the American College of Surgeon Trauma Quality Improvement Program database (2017-2021) included patients aged 14 to 18 years with severe TBI.
Acta Neurol Belg
March 2025
Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Traumatic brain injury (TBI) is a widespread, serious public health concern with substantial lasting effects, such as impacting the endocrine system. Here, we review the complications and consequences of TBI on the hypothalamic-pituitary axis (HPA) and connected endocrine glands, which are essential for maintaining body balance. Endocrine dysfunctions caused by TBI, especially hypopituitarism, can result in hormonal imbalances that impact various physiological systems, such as growth, metabolism, reproduction, and stress responses.
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