Skip to main content
Erschienen in: Monatsschrift Kinderheilkunde 11/2019

09.09.2019 | Computertomografie | Leitthema

Management des Schädel-Hirn-Traumas im Kindesalter

verfasst von: Dr. M. Lehner, S. Deininger, D. Wendling-Keim

Erschienen in: Monatsschrift Kinderheilkunde | Ausgabe 11/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Unfälle sind die häufigste Ursache für eine stationäre Aufnahme im Kindes- und Jugendalter. Etwa 90 % der tödlichen Unfallfolgen im Kindesalter sind durch das Schädel-Hirn-Trauma (SHT) bedingt. Die Einteilung erfolgt gemäß der an Kinder adaptierten Glasgow Coma Scale (GCS) und wird in 3 Grade (leicht – mittel – schwer) unterteilt. Die Behandlung des mittelgradigen und des schweren SHT muss bereits präklinisch unter Vermeidung von Hypotension und Hypoxie beginnen, da diese beiden Parameter das Outcome wesentlich beeinflussen. Bei diesen Patienten sollte eine Einweisung durch den Notarzt in ein Traumazentrum für Kinder erfolgen.
In etwa 85 % der Fälle wird ein leichtes SHT diagnostiziert. Dennoch können in dieser Gruppe klinisch entscheidende – und damit z. T. operativ zu versorgende – intrakranielle Verletzungen vorkommen. Es gilt nun, diese Patienten innerhalb des Beobachtungszeitraums von 48 h zu diagnostizieren. Im Kindesalter sollte die stationäre Überwachung vor der (primären) bildgebenden kranialen Computertomographie (cCT) stehen, um nicht unnötige Strahlung bei einem mit hoher Wahrscheinlichkeit unauffälligen Befund zu applizieren. Mittlerweile sind gut validierte Algorithmen publiziert (PECARN Rules), nach denen sich die Indikation zur kranialen schnittbildgebenden Untersuchung richten kann.
Beim schweren SHT im Kindesalter steht neben einer zielgerichteten und raschen Patientenversorgung im Schockraum, einschließlich neuroradiologischer Diagnostik, die Überwachung auf der Kinderintensivstation im Vordergrund. Kinder neigen zur Ausbildung von posttraumatischen Hirnödemen; diese gilt es zunächst, medikamentös zu behandeln. Die aktuellen Handlungsempfehlungen der Brain Trauma Foundation werden diskutiert.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Bundesarbeitsgemeinschaft mehr Sicherheit für Kinder e. V. Bonn. 2016 Bundesarbeitsgemeinschaft mehr Sicherheit für Kinder e. V. Bonn. 2016
2.
Zurück zum Zitat Vernet O, Lutz N, Rilliet N, Schlaepfer R (2004) Betreuung des kindlichen Schädelhirntraumas. Paediatrica 15(4):43–47 Vernet O, Lutz N, Rilliet N, Schlaepfer R (2004) Betreuung des kindlichen Schädelhirntraumas. Paediatrica 15(4):43–47
3.
Zurück zum Zitat Kuppermann N et al (2009) Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696):1160–1170PubMedCrossRef Kuppermann N et al (2009) Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 374(9696):1160–1170PubMedCrossRef
4.
Zurück zum Zitat Palchak MJ, Holmes JF, Kuppermann N (2009) Clinician judgment versus a decision rule for identifying children at risk of traumatic brain injury on computed tomography after blunt head trauma. Pediatr Emerg Care 25(2):61–65PubMedCrossRef Palchak MJ, Holmes JF, Kuppermann N (2009) Clinician judgment versus a decision rule for identifying children at risk of traumatic brain injury on computed tomography after blunt head trauma. Pediatr Emerg Care 25(2):61–65PubMedCrossRef
5.
Zurück zum Zitat Holmes JF et al (2009) Guardian availability in children evaluated in the emergency department for blunt head trauma. Acad Emerg Med 16(1):15–20PubMedCrossRef Holmes JF et al (2009) Guardian availability in children evaluated in the emergency department for blunt head trauma. Acad Emerg Med 16(1):15–20PubMedCrossRef
6.
Zurück zum Zitat Nigrovic LE et al (2012) Prevalence of clinically important traumatic brain injuries in children with minor blunt head trauma and isolated severe injury mechanisms. Arch Pediatr Adolesc Med 166(4):356–361PubMedCrossRef Nigrovic LE et al (2012) Prevalence of clinically important traumatic brain injuries in children with minor blunt head trauma and isolated severe injury mechanisms. Arch Pediatr Adolesc Med 166(4):356–361PubMedCrossRef
7.
Zurück zum Zitat Nigrovic LE et al (2011) The effect of observation on cranial computed tomography utilization for children after blunt head trauma. Pediatr Electron Pages 127(6):1067–1073 Nigrovic LE et al (2011) The effect of observation on cranial computed tomography utilization for children after blunt head trauma. Pediatr Electron Pages 127(6):1067–1073
8.
Zurück zum Zitat Nigrovic LE et al (2015) Quality improvement effort to reduce cranial CTs for children with minor blunt head trauma. Pediatr Electron Pages 136(1):e227–e233 Nigrovic LE et al (2015) Quality improvement effort to reduce cranial CTs for children with minor blunt head trauma. Pediatr Electron Pages 136(1):e227–e233
9.
Zurück zum Zitat Babl FE et al (2017) Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study. Lancet 389(10087):2393–2402PubMedCrossRef Babl FE et al (2017) Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study. Lancet 389(10087):2393–2402PubMedCrossRef
10.
Zurück zum Zitat Leitlinie (2011) Das Schädel-Hirn-Trauma im Kindesalter. AWMF online Leitlinie (2011) Das Schädel-Hirn-Trauma im Kindesalter. AWMF online
11.
Zurück zum Zitat Lehner M, Krohn C (2013) Leichtes Schädel-Hirn-Trauma im Kindesalter. Monatsschr Kinderheilkd 161:49–56CrossRef Lehner M, Krohn C (2013) Leichtes Schädel-Hirn-Trauma im Kindesalter. Monatsschr Kinderheilkd 161:49–56CrossRef
12.
Zurück zum Zitat Kristman VL et al (2014) Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil 95(3 Suppl):S265–S277PubMedCrossRef Kristman VL et al (2014) Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil 95(3 Suppl):S265–S277PubMedCrossRef
13.
Zurück zum Zitat Emami P et al (2017) Impact of Glasgow Coma Scale score and pupil parameters on mortality rate and outcome in pediatric and adult severe traumatic brain injury: a retrospective, multicenter cohort study. J Neurosurg 126(3):760–767PubMedCrossRef Emami P et al (2017) Impact of Glasgow Coma Scale score and pupil parameters on mortality rate and outcome in pediatric and adult severe traumatic brain injury: a retrospective, multicenter cohort study. J Neurosurg 126(3):760–767PubMedCrossRef
14.
Zurück zum Zitat Lehner M et al (2018) iTRAPS—Interdisziplinary Trauma Rooma Algorithm in Pediatric Surgery. Notfall Rettungsmed 21(2):90–99CrossRef Lehner M et al (2018) iTRAPS—Interdisziplinary Trauma Rooma Algorithm in Pediatric Surgery. Notfall Rettungsmed 21(2):90–99CrossRef
15.
Zurück zum Zitat Chiaretti A et al (2002) The impact of initial management on the outcome of children with severe head injury. Childs Nerv Syst 18(1–2):54–60PubMedCrossRef Chiaretti A et al (2002) The impact of initial management on the outcome of children with severe head injury. Childs Nerv Syst 18(1–2):54–60PubMedCrossRef
16.
Zurück zum Zitat Chiaretti A et al (2002) Prognostic factors and outcome of children with severe head injury: an 8‑year experience. Childs Nerv Syst 18(3–4):129–136PubMedCrossRef Chiaretti A et al (2002) Prognostic factors and outcome of children with severe head injury: an 8‑year experience. Childs Nerv Syst 18(3–4):129–136PubMedCrossRef
17.
Zurück zum Zitat Spaite DW et al (2017) The effect of combined out-of-hospital hypotension and hypoxia on mortality in major traumatic brain injury. Ann Emerg Med 69(1):62–72PubMedCrossRef Spaite DW et al (2017) The effect of combined out-of-hospital hypotension and hypoxia on mortality in major traumatic brain injury. Ann Emerg Med 69(1):62–72PubMedCrossRef
18.
Zurück zum Zitat Spaite DW et al (2017) Association of out-of-hospital hypotension depth and duration with traumatic brain injury mortality. Ann Emerg Med 70(4):522e1–530CrossRef Spaite DW et al (2017) Association of out-of-hospital hypotension depth and duration with traumatic brain injury mortality. Ann Emerg Med 70(4):522e1–530CrossRef
19.
Zurück zum Zitat Muhm M et al (2013) Assessment of prehospital injury severity in children: challenge for emergency physicians. Anaesthesist 62(5):380–388PubMedCrossRef Muhm M et al (2013) Assessment of prehospital injury severity in children: challenge for emergency physicians. Anaesthesist 62(5):380–388PubMedCrossRef
20.
Zurück zum Zitat Pearce MS et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380(9840):499–505PubMedPubMedCentralCrossRef Pearce MS et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380(9840):499–505PubMedPubMedCentralCrossRef
21.
Zurück zum Zitat Miglioretti DL et al (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167(8):700–707PubMedPubMedCentralCrossRef Miglioretti DL et al (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167(8):700–707PubMedPubMedCentralCrossRef
22.
Zurück zum Zitat Schonfeld D, Fitz BM, Nigrovic LE (2013) Effect of the duration of emergency department observation on computed tomography use in children with minor blunt head trauma. Ann Emerg Med 62(6):597–603PubMedCrossRef Schonfeld D, Fitz BM, Nigrovic LE (2013) Effect of the duration of emergency department observation on computed tomography use in children with minor blunt head trauma. Ann Emerg Med 62(6):597–603PubMedCrossRef
23.
Zurück zum Zitat Hennelly KE et al (2013) Pediatric traumatic brain injury and radiation risks: a clinical decision analysis. J Pediatr 162(2):392–397PubMedCrossRef Hennelly KE et al (2013) Pediatric traumatic brain injury and radiation risks: a clinical decision analysis. J Pediatr 162(2):392–397PubMedCrossRef
25.
Zurück zum Zitat Nigrovic LE et al (2013) Nurse and physician agreement in the assessment of minor blunt head trauma. Pediatr Electron Pages 132(3):e689–94 Nigrovic LE et al (2013) Nurse and physician agreement in the assessment of minor blunt head trauma. Pediatr Electron Pages 132(3):e689–94
26.
Zurück zum Zitat Osmond MH et al (2010) CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. CMAJ 182(4):341–348PubMedPubMedCentralCrossRef Osmond MH et al (2010) CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. CMAJ 182(4):341–348PubMedPubMedCentralCrossRef
27.
Zurück zum Zitat Dunning J et al (2006) Derivation of the children’s head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child 91(11):885–891PubMedPubMedCentralCrossRef Dunning J et al (2006) Derivation of the children’s head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child 91(11):885–891PubMedPubMedCentralCrossRef
28.
Zurück zum Zitat Lyttle MD et al (2013) Applicability of the CATCH, CHALICE and PECARN paediatric head injury clinical decision rules: pilot data from a single Australian centre. Emerg Med J 30(10):790–794PubMedCrossRef Lyttle MD et al (2013) Applicability of the CATCH, CHALICE and PECARN paediatric head injury clinical decision rules: pilot data from a single Australian centre. Emerg Med J 30(10):790–794PubMedCrossRef
29.
Zurück zum Zitat Lyttle MD et al (2012) Comparing CATCH, CHALICE and PECARN clinical decision rules for paediatric head injuries. Emerg Med J 29(10):785–794PubMedCrossRef Lyttle MD et al (2012) Comparing CATCH, CHALICE and PECARN clinical decision rules for paediatric head injuries. Emerg Med J 29(10):785–794PubMedCrossRef
30.
Zurück zum Zitat Schutzman SA et al (2001) Evaluation and management of children younger than two years old with apparently minor head trauma: proposed guidelines. Pediatr Electron Pages 107(5):983–993 Schutzman SA et al (2001) Evaluation and management of children younger than two years old with apparently minor head trauma: proposed guidelines. Pediatr Electron Pages 107(5):983–993
31.
Zurück zum Zitat Easter JS et al (2014) Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study. Ann Emerg Med 64(2):145–52, 152 e1–5PubMedPubMedCentralCrossRef Easter JS et al (2014) Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study. Ann Emerg Med 64(2):145–52, 152 e1–5PubMedPubMedCentralCrossRef
33.
Zurück zum Zitat Wendling-Keim DS et al (2017) Ambulatory or inpatient management of mild TBI in children: a post-concussion analysis. Pediatr Surg Int 33(2):249–261PubMedCrossRef Wendling-Keim DS et al (2017) Ambulatory or inpatient management of mild TBI in children: a post-concussion analysis. Pediatr Surg Int 33(2):249–261PubMedCrossRef
34.
Zurück zum Zitat Badawy MK et al (2017) Prevalence of brain injuries and recurrence of seizures in children with posttraumatic seizures. Acad Emerg Med 24(5):595–605PubMedCrossRef Badawy MK et al (2017) Prevalence of brain injuries and recurrence of seizures in children with posttraumatic seizures. Acad Emerg Med 24(5):595–605PubMedCrossRef
35.
Zurück zum Zitat Lee LK et al (2014) Isolated loss of consciousness in children with minor blunt head trauma. JAMA Pediatr 168(9):837–843PubMedCrossRef Lee LK et al (2014) Isolated loss of consciousness in children with minor blunt head trauma. JAMA Pediatr 168(9):837–843PubMedCrossRef
36.
Zurück zum Zitat Dayan PS et al (2014) Risk of traumatic brain injuries in children younger than 24 months with isolated scalp hematomas. Ann Emerg Med 64(2):153–162PubMedCrossRef Dayan PS et al (2014) Risk of traumatic brain injuries in children younger than 24 months with isolated scalp hematomas. Ann Emerg Med 64(2):153–162PubMedCrossRef
37.
Zurück zum Zitat Burns EC et al (2016) Scalp hematoma characteristics associated with Intracranial injury in pediatric minor head injury. Acad Emerg Med 23(5):576–583PubMedCrossRef Burns EC et al (2016) Scalp hematoma characteristics associated with Intracranial injury in pediatric minor head injury. Acad Emerg Med 23(5):576–583PubMedCrossRef
38.
Zurück zum Zitat Erlichman DB et al (2010) Association between linear skull fractures and intracranial hemorrhage in children with minor head trauma. Pediatr Radiol 40(8):1375–1379PubMedCrossRef Erlichman DB et al (2010) Association between linear skull fractures and intracranial hemorrhage in children with minor head trauma. Pediatr Radiol 40(8):1375–1379PubMedCrossRef
39.
Zurück zum Zitat Da Dalt L et al (2007) Characteristics of children with vomiting after minor head trauma: a case-control study. J Pediatr 150(3):274–278PubMedCrossRef Da Dalt L et al (2007) Characteristics of children with vomiting after minor head trauma: a case-control study. J Pediatr 150(3):274–278PubMedCrossRef
40.
Zurück zum Zitat Dayan PS et al (2014) Association of traumatic brain injuries with vomiting in children with blunt head trauma. Ann Emerg Med 63(6):657–665PubMedCrossRef Dayan PS et al (2014) Association of traumatic brain injuries with vomiting in children with blunt head trauma. Ann Emerg Med 63(6):657–665PubMedCrossRef
41.
Zurück zum Zitat Dayan PS et al (2015) Headache in traumatic brain injuries from blunt head trauma. Pediatr Electron Pages 135(3):504–512 Dayan PS et al (2015) Headache in traumatic brain injuries from blunt head trauma. Pediatr Electron Pages 135(3):504–512
42.
Zurück zum Zitat Irvine A, Babul S, Goldman RD (2017) Return to learn after concussion in children. Can Fam Physician 63(11):859–862PubMedPubMedCentral Irvine A, Babul S, Goldman RD (2017) Return to learn after concussion in children. Can Fam Physician 63(11):859–862PubMedPubMedCentral
43.
Zurück zum Zitat Bernard CO et al (2016) Predictors of post-concussive symptoms in young children: injury versus non-injury related factors. J Int Neuropsychol Soc 22(8):793–803PubMedCrossRef Bernard CO et al (2016) Predictors of post-concussive symptoms in young children: injury versus non-injury related factors. J Int Neuropsychol Soc 22(8):793–803PubMedCrossRef
44.
45.
Zurück zum Zitat Petzold A et al (2003) Cerebrospinal fluid (CSF) and serum S100B: release and wash-out pattern. Brain Res Bull 61(3):281–285PubMedCrossRef Petzold A et al (2003) Cerebrospinal fluid (CSF) and serum S100B: release and wash-out pattern. Brain Res Bull 61(3):281–285PubMedCrossRef
46.
Zurück zum Zitat Townend W et al (2006) Rapid elimination of protein S‑100B from serum after minor head trauma. J Neurotrauma 23(2):149–155PubMedCrossRef Townend W et al (2006) Rapid elimination of protein S‑100B from serum after minor head trauma. J Neurotrauma 23(2):149–155PubMedCrossRef
47.
Zurück zum Zitat Oris C et al (2018) The biomarker S100B and mild traumatic brain injury: a meta-analysis. Pediatrics 141(6):e20180037PubMedCrossRef Oris C et al (2018) The biomarker S100B and mild traumatic brain injury: a meta-analysis. Pediatrics 141(6):e20180037PubMedCrossRef
48.
Zurück zum Zitat Bouvier D et al (2019) Assessment of the advantage of the serum S100B protein biomonitoring in the management of paediatric mild traumatic brain injury-PROS100B: protocol of a multicentre unblinded stepped wedge cluster randomised trial. BMJ Open 9(5):e27365PubMedPubMedCentralCrossRef Bouvier D et al (2019) Assessment of the advantage of the serum S100B protein biomonitoring in the management of paediatric mild traumatic brain injury-PROS100B: protocol of a multicentre unblinded stepped wedge cluster randomised trial. BMJ Open 9(5):e27365PubMedPubMedCentralCrossRef
49.
Zurück zum Zitat Lehner M et al (2018) Reduction of treatment time for children in the trauma room care : impact of implementation of an interdisciplinary trauma room concept (iTRAP(S)). Anaesthesist 67(12):914–921PubMedCrossRef Lehner M et al (2018) Reduction of treatment time for children in the trauma room care : impact of implementation of an interdisciplinary trauma room concept (iTRAP(S)). Anaesthesist 67(12):914–921PubMedCrossRef
50.
Zurück zum Zitat Wyen H et al (2010) Prehospital and early clinical care of infants, children, and teenagers compared to an adult cohort : analysis of 2,961 children in comparison to 21,435 adult patients from the trauma registry of DGU in a 15-year period. Eur J Trauma Emerg Surg 36(4):300–307PubMedCrossRef Wyen H et al (2010) Prehospital and early clinical care of infants, children, and teenagers compared to an adult cohort : analysis of 2,961 children in comparison to 21,435 adult patients from the trauma registry of DGU in a 15-year period. Eur J Trauma Emerg Surg 36(4):300–307PubMedCrossRef
51.
Zurück zum Zitat Murphy S et al (2017) Tripartite stratification of the Glasgow coma scale in children with severe traumatic brain injury and mortality: an analysis from a multi-center comparative effectiveness study. J Neurotrauma 34(14):2220PubMedCentralPubMedCrossRef Murphy S et al (2017) Tripartite stratification of the Glasgow coma scale in children with severe traumatic brain injury and mortality: an analysis from a multi-center comparative effectiveness study. J Neurotrauma 34(14):2220PubMedCentralPubMedCrossRef
52.
Zurück zum Zitat Miller Ferguson N et al (2017) Abusive head trauma and mortality-an analysis from an international comparative effectiveness study of children with severe traumatic brain injury. Crit Care Med 45(8):1398–1407PubMedCrossRef Miller Ferguson N et al (2017) Abusive head trauma and mortality-an analysis from an international comparative effectiveness study of children with severe traumatic brain injury. Crit Care Med 45(8):1398–1407PubMedCrossRef
53.
Zurück zum Zitat Bell MJ et al (2017) Challenges and opportunities for pediatric severe TBI-review of the evidence and exploring a way forward. Childs Nerv Syst 33(10):1663–1667PubMedCrossRef Bell MJ et al (2017) Challenges and opportunities for pediatric severe TBI-review of the evidence and exploring a way forward. Childs Nerv Syst 33(10):1663–1667PubMedCrossRef
54.
Zurück zum Zitat Kochanek PM et al (2019) Guidelines for the management of pediatric severe traumatic brain injury, third edition: update of the brain trauma foundation guidelines, executive summary. Neurosurgery 84(6):1169–1178PubMedCrossRef Kochanek PM et al (2019) Guidelines for the management of pediatric severe traumatic brain injury, third edition: update of the brain trauma foundation guidelines, executive summary. Neurosurgery 84(6):1169–1178PubMedCrossRef
55.
Zurück zum Zitat Allen BB et al (2014) Age-specific cerebral perfusion pressure thresholds and survival in children and adolescents with severe traumatic brain injury. Pediatr Crit Care Med 15(1):62–70PubMedPubMedCentralCrossRef Allen BB et al (2014) Age-specific cerebral perfusion pressure thresholds and survival in children and adolescents with severe traumatic brain injury. Pediatr Crit Care Med 15(1):62–70PubMedPubMedCentralCrossRef
56.
Zurück zum Zitat Shein SL et al (2016) Effectiveness of pharmacological therapies for Intracranial hypertension in children with severe traumatic brain injury—results from an automated data collection system time-synched to drug administration. Pediatr Crit Care Med 17(3):236–245PubMedPubMedCentralCrossRef Shein SL et al (2016) Effectiveness of pharmacological therapies for Intracranial hypertension in children with severe traumatic brain injury—results from an automated data collection system time-synched to drug administration. Pediatr Crit Care Med 17(3):236–245PubMedPubMedCentralCrossRef
57.
Zurück zum Zitat Ketharanathan N et al (2017) Analgosedation in paediatric severe traumatic brain injury (TBI): practice, pitfalls and possibilities. Childs Nerv Syst 33(10):1703–1710PubMedPubMedCentralCrossRef Ketharanathan N et al (2017) Analgosedation in paediatric severe traumatic brain injury (TBI): practice, pitfalls and possibilities. Childs Nerv Syst 33(10):1703–1710PubMedPubMedCentralCrossRef
58.
Zurück zum Zitat Guilliams K, Wainwright MS (2016) Pathophysiology and management of moderate and severe traumatic brain injury in children. J Child Neurol 31(1):35–45PubMedCrossRef Guilliams K, Wainwright MS (2016) Pathophysiology and management of moderate and severe traumatic brain injury in children. J Child Neurol 31(1):35–45PubMedCrossRef
59.
Zurück zum Zitat Mtaweh H, Bell MJ (2015) Management of pediatric traumatic brain injury. Curr Treat Options Neurol 17(5):348PubMedCrossRef Mtaweh H, Bell MJ (2015) Management of pediatric traumatic brain injury. Curr Treat Options Neurol 17(5):348PubMedCrossRef
60.
Zurück zum Zitat Mellion SA et al (2013) High-dose barbiturates for refractory intracranial hypertension in children with severe traumatic brain injury. Pediatr Crit Care Med 14(3):239–247PubMedCrossRef Mellion SA et al (2013) High-dose barbiturates for refractory intracranial hypertension in children with severe traumatic brain injury. Pediatr Crit Care Med 14(3):239–247PubMedCrossRef
62.
Zurück zum Zitat Beca J et al (2015) Hypothermia for traumatic brain injury in children—a phase II randomized controlled trial. Crit Care Med 43(7):1458–1466PubMedCrossRef Beca J et al (2015) Hypothermia for traumatic brain injury in children—a phase II randomized controlled trial. Crit Care Med 43(7):1458–1466PubMedCrossRef
63.
Zurück zum Zitat Pechmann A et al (2015) Decompressive craniectomy after severe traumatic brain injury in children: complications and outcome. Neuropediatrics 46(1):5–12PubMedCrossRef Pechmann A et al (2015) Decompressive craniectomy after severe traumatic brain injury in children: complications and outcome. Neuropediatrics 46(1):5–12PubMedCrossRef
64.
Zurück zum Zitat Prasad GL et al (2015) Surgical results of decompressive craniectomy in very young children: a level one trauma centre experience from India. Brain Inj 29(13–14):1717–1724PubMedCrossRef Prasad GL et al (2015) Surgical results of decompressive craniectomy in very young children: a level one trauma centre experience from India. Brain Inj 29(13–14):1717–1724PubMedCrossRef
65.
Zurück zum Zitat Ferrazzano PA et al (2019) Use of magnetic resonance imaging in severe pediatric traumatic brain injury: assessment of current practice. J Neurosurg Pediatr p:1–9 Ferrazzano PA et al (2019) Use of magnetic resonance imaging in severe pediatric traumatic brain injury: assessment of current practice. J Neurosurg Pediatr p:1–9
Metadaten
Titel
Management des Schädel-Hirn-Traumas im Kindesalter
verfasst von
Dr. M. Lehner
S. Deininger
D. Wendling-Keim
Publikationsdatum
09.09.2019
Verlag
Springer Medizin
Erschienen in
Monatsschrift Kinderheilkunde / Ausgabe 11/2019
Print ISSN: 0026-9298
Elektronische ISSN: 1433-0474
DOI
https://doi.org/10.1007/s00112-019-00770-5

Weitere Artikel der Ausgabe 11/2019

Monatsschrift Kinderheilkunde 11/2019 Zur Ausgabe

Mitteilungen der DGKJ

Mitteilungen der DGKJ

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.