Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Every year 300,000 children with accidental head trauma are admitted to Italian emergency departments. Our aims were: (1) to describe patients with minor traumatic brain injury who were admitted to pediatric departments and underwent CT, and (2) to analyze the appropriateness of management according to current guidelines. ⋯ The best way to manage children with minor head trauma is still matter of debate. Loss of consciousness and scalp swelling are risk factors predicting brain injury that deserve CT control. The radiation risks posed by CT scanning in children must be balanced by the benefits. We believe that even though CT scans may be clinically unnecessary in many cases, the rate of scanning is justified by the even limited number of abnormalities which require neurosurgical treatment.
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The finite life of non-rechargeable batteries powering implantable pulse generators (IPG) necessitates their periodic replacement. Children receiving deep brain stimulation (DBS) may require frequent battery changes over their treatment lifetime. ⋯ IPG battery life may be short in children and young people receiving treatment for dystonia. These findings highlight the potential benefits of the recently introduced rechargeable neurostimulators.
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Traumatic brain injury is an important cause of morbidity and mortality in children and adolescents. Moderate to severe brain injuries account for approximately 20 % of all brain injuries, and nearly 50 % of the patients experience neuropsychological sequelae due to the injury. The purposes of this study are, firstly, to describe intensive care management of children with a severe brain injury and, secondly, to study the impact of elevated intracranial pressure on outcome. ⋯ Children receiving rehabilitation after a brain injury during childhood make a moderate to good recovery. No significant correlation was found between outcome and whether or not the child had been treated for elevated intracranial pressure.
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The purpose of the study was to determine the developmental prognostic significance of early clinical indicators in abusive head trauma. ⋯ This study demonstrates that clinical factors at the time of injury, such as early post-traumatic seizures and intubation requirement, are associated with poorer developmental outcome. This study also suggests that close developmental follow-up should be obtained for all children with abusive head trauma, regardless of whether or not the child was admitted to the PICU.