Accidental head injury

A Viewpoint on Treatment of Traumatic Bilateral Basal Ganglia Hemorrhage in a Child: Case Report

Traumatic basal ganglia hemorrhage (TBGH) is a rare presentation of head injuries. Bilateral lesions are extremely rare. The pathophysiologic mechanism of bilateral TBGH seems to be the same as diffuse axonal injury. However, limited information about childhood bilateral TBGH is available in the literature. We report the case of a child with bilateral TBGH treated with stereotactic aspiration of hemorrhage and periodic urokinase irrigation.

Susceptibility to injury during a fall among blind children

Introduction: The aim of this study was examine the relationship between ability of safe falls and occurrence injuries from the effect of falls, among blind children.

Material and methods: More than one hundred children (10-16 years old) was in research and control groups. In the research group was 51 blind people, in control group 66 sighted in a proper manner. Test of Susceptibility to Injury During the Falls (TSIDF) by Kalina and interview directed to determine the number and frequency of falls and their consequences (number and type of injuries) and selected lifestyle factors were used as a research tools.

Results: Blind children made more mistakes in test (TSIDF) than their non-disabled peers (although they are trained to safe falls). This may prove that a high susceptibility to injury of the children from the research group. However blind people had more injuries after the falls. Study confirmed positive effect of physical activity on the level of safe falls skills.

Conclusion: Physical fitness, physical activity and especially exercises of safe falls skills can be important element of prevention of falls. This concern to high-risk groups, such as blind people.

Post accessive social policy in the rehabilitation of adolescents following TBI

BACKGROUND

The aim of this research was to evaluate the effectiveness of the post-accessive Conduct Disorder Therapy Program administered within the "Academy of Life" in the reduction of behavioural disorder in adolescents following traumatic brain injury (TBI).

MATERIAL/METHODS

100 adolescents from Gdansk and adjacent areas, psychiatrically diagnosed with "frontal lobe syndrome" following a TBI, were examined. Group A included 50 participants examined and treated at the Reintegration and Training Center of the Foundation for Persons with Brain Dysfunctions. Group B comprised 50 people matched for age and sex, under treatment at the Gdansk Center for Neuropsychological Studies, Gdansk-Południe Non-Public Health Care Center. Group A used the above therapy programme, while group B did not. The studies included an analysis of documentation, neuro-imaging (CT or MRI), clinical interviews, the Mini-Mental State Examination and the Frontal Behavioural Inventory.

RESULTS

The therapy program had a significant impact on conduct disorders, the most visible differences being within neurological disorders and the least visible within cognitive disorders. It also influenced the social reintegration of adolescents following TBI, as demonstrated by the greater increase in the percentage of participants from group A returning to school and hobbies practised before the accident.

CONCLUSIONS

The results indicate that the evaluated therapy program is effective in reducing behavioral disorders in adolescents following brain injury, and their reintegration into society.

Mild traumatic brain injury in children: just another bump on the head?

Mild traumatic brain injury (MTBI) is frequently encountered in pediatrics and challenges healthcare practitioners to provide safe, consistent, cost-effective care. Clinical management of children who sustain MTBI poses dilemmas for healthcare practitioners. This article will provide an overview of pediatric MTBI including definition, issues impacting diagnosis and management, risk factors for intracranial injury, indications for diagnostic imaging, disposition, and return to sports/activity. Knowledge and understanding of MTBI in children aid healthcare practitioners to make informed competent recommendations for care. Clinicians must have a thorough understanding and working knowledge of pediatric MTBI to aid clinical decisions and optimize patient outcomes.

Traumatic brain injury in the immature mouse brain: characterization of regional vulnerability

We characterized the regional and temporal patterns of neuronal injury and axonal degeneration after controlled cortical impact of moderate severity in mice at postnatal day 21. Animals were euthanized at 1, 3, or 7 days after injury or sham operation. The brains were removed and prepared for immunolocalization of neurons and microglia/macrophages or subjected to Fluoro-Jade and silver stains, indicators of irreversible neuronal cell injury and axonal degeneration. There was significant neuronal loss in both the ipsi- and the contralateral cortices, ipsilateral hippocampus, and ipsilateral thalamus by 7 days post injury compared to sham-operated animals. Activated microglia/macrophages were most prominent in regions of neuronal loss including the ipsilateral cortex, hippocampus, and thalamus. Neuronal injury, as evidenced by Fluoro-Jade labeling, was not apparent in sham-operated animals. In injured animals, labeling was identified in the ipsilateral cortex and hippocampus at 1 and 3 days post injury. Silver- and Fluoro-Jade-labeled degenerating axons were observed in the ipsilateral subcortical white matter by 1 day post injury, in the ipsilateral external capsule, caudate putamen, and contralateral subcortical white matter by 3 days post injury, and in the internal capsule, pyramidal tracts, and cerebellar peduncles by 7 days post injury. Our findings demonstrate that controlled cortical impact in the developing brain generates neuronal loss in both the ipsilateral and the contralateral cortex, a temporally distinct pattern of subcortical neuronal injury/death, and widespread white matter damage. These observations serve as an important baseline for studying human brain injury and optimizing therapies for the brain-injured child.

Minor head injury in the pediatric patient

Minor head injury is a common occurrence in children of all ages; however, controversy exists regarding the management of these children. Reports of neurologically intact children with intracranial injuries have caused many to recommend cautious management, while the infrequency of serious intracranial injuries after minor head trauma have prompted others to be less conservative. Based on recent literature reports, strategies for the management of children with minor head trauma are presented.

Practical issues in the care of pediatric trauma patients

Childhood injuries are a preventable problem that continue to occur with alarming frequency. The pediatrician has a broad role in the prevention and treatment of injuries. When primary prevention fails, trauma care providers must recognize that an injured child is a unique patient who requires special considerations. Use of an organized approach will assure that injuries are not missed. The care of an injured child presents pediatricians with a tremendous responsibility. Injury prevention presents the pediatrician with a formidable challenge.