Pediatric emergency medicine trisk 3635 3635

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.
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