Skip to main content
Erschienen in: Child's Nervous System 2/2010

01.02.2010 | Focus Session

Should pediatric neurosurgeons still manage neurotrauma today?

verfasst von: Jonathan C. Peter

Erschienen in: Child's Nervous System | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Neurotrauma remains a major global burden of injury, especially for young patients, and will consequently always be a condition that pediatric neurosurgeons are called upon to treat. However, the face of modern neurotrauma management is changing, presenting important challenges to today’s pediatric neurosurgeons.

Objective

This article summarizes some of the issues in neurotrauma facing clinicians whose responsibility it is to treat these children.

Conclusion

It is up to the individual neurosurgeon to familiarize him- or herself with the emerging literature on the modern management of pediatric neurotrauma.
Literatur
1.
Zurück zum Zitat Arias E, Anderson RN, Kung HC, Murphy SL, Kochanek KD (2003) Deaths: final data for 2001. National Vital Statistics Reports 52(3):1–116PubMed Arias E, Anderson RN, Kung HC, Murphy SL, Kochanek KD (2003) Deaths: final data for 2001. National Vital Statistics Reports 52(3):1–116PubMed
2.
Zurück zum Zitat Bowman SM, Martin DP, Sharar SR, Zimmerman FJ (2007) Racial disparities in outcomes of persons with moderate to severe traumatic brain injury. Med Care 45(7):686–690CrossRefPubMed Bowman SM, Martin DP, Sharar SR, Zimmerman FJ (2007) Racial disparities in outcomes of persons with moderate to severe traumatic brain injury. Med Care 45(7):686–690CrossRefPubMed
3.
Zurück zum Zitat Bradshaw D, Bourne D, Nannan N (2003) What are the leading causes of death among South African children? South African Medical Research Council Policy Brief, 3 (December 2003) Bradshaw D, Bourne D, Nannan N (2003) What are the leading causes of death among South African children? South African Medical Research Council Policy Brief, 3 (December 2003)
4.
Zurück zum Zitat Bulger EM, Nathens AB, Rivara FP, Moore M, MacKenzie EJ, Jurkovich GJ, Foundation BT (2002) Management of severe head injury: Institutional variations in care and effect on outcome. Crit Care Med 30(8):1870–1876CrossRefPubMed Bulger EM, Nathens AB, Rivara FP, Moore M, MacKenzie EJ, Jurkovich GJ, Foundation BT (2002) Management of severe head injury: Institutional variations in care and effect on outcome. Crit Care Med 30(8):1870–1876CrossRefPubMed
5.
Zurück zum Zitat Cantais E, Paut O, Giorgi R, Viard L, Camboulives J (2001) Evaluating the prognosis of multiple, severely traumatized children in the intensive care unit. Intensive Care Med 27(9):1511–1517CrossRefPubMed Cantais E, Paut O, Giorgi R, Viard L, Camboulives J (2001) Evaluating the prognosis of multiple, severely traumatized children in the intensive care unit. Intensive Care Med 27(9):1511–1517CrossRefPubMed
6.
Zurück zum Zitat Carli P, Orliaguet G (2004) Severe traumatic brain injury in children. Lancet 363(9409):584–585CrossRefPubMed Carli P, Orliaguet G (2004) Severe traumatic brain injury in children. Lancet 363(9409):584–585CrossRefPubMed
8.
Zurück zum Zitat Coles JP, Fryer TD, Coleman MR, Smielewski P, Gupta AK, Minhas PS, Aigbirhio F, Chatfield DA, Williams GB, Boniface S, Carpenter TA, Clark JC, Pickard JD, Menon DK (2007) Hyperventilation following head injury: effect on ischemic burden and cerebral oxidative metabolism. Crit Care Med 35(2):568–578CrossRefPubMed Coles JP, Fryer TD, Coleman MR, Smielewski P, Gupta AK, Minhas PS, Aigbirhio F, Chatfield DA, Williams GB, Boniface S, Carpenter TA, Clark JC, Pickard JD, Menon DK (2007) Hyperventilation following head injury: effect on ischemic burden and cerebral oxidative metabolism. Crit Care Med 35(2):568–578CrossRefPubMed
9.
Zurück zum Zitat Dean NP, Boslaugh S, Adelson PD, Pineda JA, Leonard JR (2007) Physician agreement with evidence-based recommendations for the treatment of severe traumatic brain injury in children. J Neurosurg 107(5):387–391PubMed Dean NP, Boslaugh S, Adelson PD, Pineda JA, Leonard JR (2007) Physician agreement with evidence-based recommendations for the treatment of severe traumatic brain injury in children. J Neurosurg 107(5):387–391PubMed
10.
Zurück zum Zitat Elf K, Nilsson P, Enblad P (2002) Outcome after traumatic brain injury improved by an organized secondary insult program and standardized neurointensive care. Crit Care Med 30(9):2129–2134CrossRefPubMed Elf K, Nilsson P, Enblad P (2002) Outcome after traumatic brain injury improved by an organized secondary insult program and standardized neurointensive care. Crit Care Med 30(9):2129–2134CrossRefPubMed
11.
Zurück zum Zitat Fakhry SM, Trask AL, Waller MA, Watts DD, Neurotrauma Task Force IRTC (2004) Management of brain-injured patients by an evidence-based medicine protocol improves outcomes and decreases hospital charges. J Trauma 56(3):492–499 discussion 499–500CrossRefPubMed Fakhry SM, Trask AL, Waller MA, Watts DD, Neurotrauma Task Force IRTC (2004) Management of brain-injured patients by an evidence-based medicine protocol improves outcomes and decreases hospital charges. J Trauma 56(3):492–499 discussion 499–500CrossRefPubMed
12.
Zurück zum Zitat Figaji AA, Fieggen AG, Argent AC, Leroux PD, Peter JC (2008) Does adherence to treatment targets in children with severe traumatic brain injury avoid brain hypoxia? A brain tissue oxygenation study. Neurosurgery 63(1):83–91 discussion 91–92CrossRefPubMed Figaji AA, Fieggen AG, Argent AC, Leroux PD, Peter JC (2008) Does adherence to treatment targets in children with severe traumatic brain injury avoid brain hypoxia? A brain tissue oxygenation study. Neurosurgery 63(1):83–91 discussion 91–92CrossRefPubMed
13.
Zurück zum Zitat Harris OA, Bruce CA, Reid M, Cheeks R, Easley K, Surles MC, Pan Y, Rhoden-Salmon D, Webster D, Crandon I (2008) Examination of the management of traumatic brain injury in the developing and developed world: Focus on resource utilization, protocols, and practices that alter outcome. J Neurosurg 109(3):433–438CrossRefPubMed Harris OA, Bruce CA, Reid M, Cheeks R, Easley K, Surles MC, Pan Y, Rhoden-Salmon D, Webster D, Crandon I (2008) Examination of the management of traumatic brain injury in the developing and developed world: Focus on resource utilization, protocols, and practices that alter outcome. J Neurosurg 109(3):433–438CrossRefPubMed
14.
Zurück zum Zitat Jin PH, Penning N, Joosse P, Hijdra AH, Bouma GJ, Ponsen KJ, Goslings JC (2008) The effect of the introduction of the amsterdam trauma workflow concept on mortality and functional outcome of patients with severe traumatic brain injury. J Neurotrauma 25(8):1003–1009CrossRef Jin PH, Penning N, Joosse P, Hijdra AH, Bouma GJ, Ponsen KJ, Goslings JC (2008) The effect of the introduction of the amsterdam trauma workflow concept on mortality and functional outcome of patients with severe traumatic brain injury. J Neurotrauma 25(8):1003–1009CrossRef
15.
Zurück zum Zitat Lam WH, MacKersie A (1999) Paediatric head injury: Incidence, aetiology and management. Paediatr Anaesth 9(5):377–385CrossRefPubMed Lam WH, MacKersie A (1999) Paediatric head injury: Incidence, aetiology and management. Paediatr Anaesth 9(5):377–385CrossRefPubMed
16.
Zurück zum Zitat Langlois JA, Rutland-Brown W, Thomas KE (2004) Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta Langlois JA, Rutland-Brown W, Thomas KE (2004) Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta
17.
Zurück zum Zitat Martin JA, Kung HC, Mathews TJ, Hoyert DL, Strobino DM, Guyer B, Sutton SR (2008) Annual summary of vital statistics: 2006. Pediatrics 121(4):788–801CrossRefPubMed Martin JA, Kung HC, Mathews TJ, Hoyert DL, Strobino DM, Guyer B, Sutton SR (2008) Annual summary of vital statistics: 2006. Pediatrics 121(4):788–801CrossRefPubMed
18.
Zurück zum Zitat Mauritz W, Wilbacher I, Majdan M, Leitgeb J, Janciak I, Brazinova A, Rusnak M (2008) Epidemiology, treatment and outcome of patients after severe traumatic brain injury in European regions with different economic status. Eur J Public Health 18(6):575–580CrossRefPubMed Mauritz W, Wilbacher I, Majdan M, Leitgeb J, Janciak I, Brazinova A, Rusnak M (2008) Epidemiology, treatment and outcome of patients after severe traumatic brain injury in European regions with different economic status. Eur J Public Health 18(6):575–580CrossRefPubMed
19.
Zurück zum Zitat Mayer T, Walker ML, Johnson DG, Matlak ME (1981) Causes of morbidity and mortality in severe pediatric trauma. JAMA 245(7):719–721CrossRefPubMed Mayer T, Walker ML, Johnson DG, Matlak ME (1981) Causes of morbidity and mortality in severe pediatric trauma. JAMA 245(7):719–721CrossRefPubMed
20.
Zurück zum Zitat Morris KP, Forsyth RJ, Parslow RC, Tasker RC, Hawley CA, UK Paediatric Traumatic Brain Injury Study Group, Paediatric Intensive Care Society Study Group (2006) Intracranial pressure complicating severe traumatic brain injury in children: Monitoring and management. Intensive Care Med 32(10):1606–1612CrossRef Morris KP, Forsyth RJ, Parslow RC, Tasker RC, Hawley CA, UK Paediatric Traumatic Brain Injury Study Group, Paediatric Intensive Care Society Study Group (2006) Intracranial pressure complicating severe traumatic brain injury in children: Monitoring and management. Intensive Care Med 32(10):1606–1612CrossRef
21.
Zurück zum Zitat Narotam PK, Morrison JF, Nathoo N (2009) Brain tissue oxygen monitoring in traumatic brain injury and major trauma: outcome analysis of a brain tissue oxygen-directed therapy. J Neurosurg 111:672–682CrossRefPubMed Narotam PK, Morrison JF, Nathoo N (2009) Brain tissue oxygen monitoring in traumatic brain injury and major trauma: outcome analysis of a brain tissue oxygen-directed therapy. J Neurosurg 111:672–682CrossRefPubMed
22.
Zurück zum Zitat Palmer S, Bader MK, Qureshi A, Palmer J, Shaver T, Borzatta M, Stalcup C (2001) The impact on outcomes in a community hospital setting of using the AANS traumatic brain injury guidelines. American Associations for Neurologic Surgeons. J Trauma 50(4):657–664CrossRefPubMed Palmer S, Bader MK, Qureshi A, Palmer J, Shaver T, Borzatta M, Stalcup C (2001) The impact on outcomes in a community hospital setting of using the AANS traumatic brain injury guidelines. American Associations for Neurologic Surgeons. J Trauma 50(4):657–664CrossRefPubMed
23.
Zurück zum Zitat Patel HC, Menon DK, Tebbs S, Hawker R, Hutchinson PJ, Kirkpatrick PJ (2002) Specialist neurocritical care and outcome from head injury. Intensive Care Med 28(5):547–553CrossRefPubMed Patel HC, Menon DK, Tebbs S, Hawker R, Hutchinson PJ, Kirkpatrick PJ (2002) Specialist neurocritical care and outcome from head injury. Intensive Care Med 28(5):547–553CrossRefPubMed
24.
Zurück zum Zitat Segui-Gomez M, MacKenzie EJ (2003) Measuring the public health impact of injuries. Epidemiol Rev 25:3–19CrossRefPubMed Segui-Gomez M, MacKenzie EJ (2003) Measuring the public health impact of injuries. Epidemiol Rev 25:3–19CrossRefPubMed
25.
Zurück zum Zitat Shafi S, de la Plata CM, Diaz-Arrastia R, Bransky A, Frankel H, Elliott AC, Parks J, Gentilello LM (2007) Ethnic disparities exist in trauma care. J Trauma 63(5):1138–1142CrossRefPubMed Shafi S, de la Plata CM, Diaz-Arrastia R, Bransky A, Frankel H, Elliott AC, Parks J, Gentilello LM (2007) Ethnic disparities exist in trauma care. J Trauma 63(5):1138–1142CrossRefPubMed
26.
Zurück zum Zitat Sharples PM, Storey A, Aynsley-Green A, Eyre JA (1990) Avoidable factors contributing to death of children with head injury. BMJ 300(6717):87–91CrossRefPubMed Sharples PM, Storey A, Aynsley-Green A, Eyre JA (1990) Avoidable factors contributing to death of children with head injury. BMJ 300(6717):87–91CrossRefPubMed
27.
Zurück zum Zitat Stiefel MF, Spiotta A, Gracias VH, Garuffe AM, Guillamondegui O, Maloney-Wilensky E, Bloom S, Grady MS, LeRoux PD (2005) Reduced mortality rate in patients with severe traumatic brain injury treated with brain tissue oxygen monitoring. J Neurosurg 103(5):805–811CrossRefPubMed Stiefel MF, Spiotta A, Gracias VH, Garuffe AM, Guillamondegui O, Maloney-Wilensky E, Bloom S, Grady MS, LeRoux PD (2005) Reduced mortality rate in patients with severe traumatic brain injury treated with brain tissue oxygen monitoring. J Neurosurg 103(5):805–811CrossRefPubMed
28.
Zurück zum Zitat Stiefel MF, Udoetuk JD, Spiotta AM, Gracias VH, Goldberg A, Maloney-Wilensky E, Bloom S, Le Roux PD (2006) Conventional neurocritical care and cerebral oxygenation after traumatic brain injury. J Neurosurg 105(4):568–575CrossRefPubMed Stiefel MF, Udoetuk JD, Spiotta AM, Gracias VH, Goldberg A, Maloney-Wilensky E, Bloom S, Le Roux PD (2006) Conventional neurocritical care and cerebral oxygenation after traumatic brain injury. J Neurosurg 105(4):568–575CrossRefPubMed
29.
Zurück zum Zitat Tepas JJ 3rd, DiScala C, Ramenofsky ML, Barlow B (1990) Mortality and head injury: the pediatric perspective. J Pediatr Surg 25(1):92–95 discussion 96CrossRefPubMed Tepas JJ 3rd, DiScala C, Ramenofsky ML, Barlow B (1990) Mortality and head injury: the pediatric perspective. J Pediatr Surg 25(1):92–95 discussion 96CrossRefPubMed
30.
Zurück zum Zitat Tilford JM, Aitken ME, Anand KJ, Green JW, Goodman AC, Parker JG, Killingsworth JB, Fiser DH, Adelson PD (2005) Hospitalizations for critically ill children with traumatic brain injuries: a longitudinal analysis. Crit Care Med 33(9):2074–2081CrossRefPubMed Tilford JM, Aitken ME, Anand KJ, Green JW, Goodman AC, Parker JG, Killingsworth JB, Fiser DH, Adelson PD (2005) Hospitalizations for critically ill children with traumatic brain injuries: a longitudinal analysis. Crit Care Med 33(9):2074–2081CrossRefPubMed
31.
Zurück zum Zitat Varelas PN, Eastwood D, Yun HJ, Spanaki MV, Hacein Bey L, Kessaris C, Gennarelli TA (2006) Impact of a neurointensivist on outcomes in patients with head trauma treated in a neurosciences intensive care unit. J Neurosurg 104(5):713–719CrossRefPubMed Varelas PN, Eastwood D, Yun HJ, Spanaki MV, Hacein Bey L, Kessaris C, Gennarelli TA (2006) Impact of a neurointensivist on outcomes in patients with head trauma treated in a neurosciences intensive care unit. J Neurosurg 104(5):713–719CrossRefPubMed
Metadaten
Titel
Should pediatric neurosurgeons still manage neurotrauma today?
verfasst von
Jonathan C. Peter
Publikationsdatum
01.02.2010
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 2/2010
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-009-1030-4

Weitere Artikel der Ausgabe 2/2010

Child's Nervous System 2/2010 Zur Ausgabe

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.